A preliminary study of mercury exposure and blood pressure in the Brazilian Amazon

Mercury in the Tapajós River basin, Brazilian Amazon: a review

This paper presents a review about mercury contamination and human exposure in the Tapajós River basin (Brazil), one of the major tributaries of the Amazon impacted by traditional gold mining from the mid 1980s. The most recent review in this region was published more than ten years ago and since then many articles about environment and especially human populations have revealed new aspects of mercury toxicology. Additionally, new biomarkers of mercury exposure and toxicity have been studied in these populations. However, there are still many open, about both mercury's biogeochemical cycle and mercury health risks. Further environmental and human risk research directions are proposed.

Mercury exposure and oxidative stress in communities of the Brazilian Amazon

This study was designed to assess possible associations between biomarkers of mercury (Hg) exposure and oxidative stress in fish-eating Amazonian communities. Clinical samples were obtained from riparians living in the Brazilian Amazon. Biomarkers of oxidative stress (glutathione - GSH, glutathione peroxidase - GSH-Px, catalase - CAT, activity and reactivation index of delta-aminolevulinate dehydratase - ALA-D (R%) were determined in blood. Total Hg was measured in whole blood (B-Hg), plasma (P-Hg) and hair (H-Hg). Association between biomarkers of Hg exposure and oxidative stress were examined using multiple regression models, including age, gender, alcohol consumption, smoking status, fish consumption and then stratified for gender. Significant inverse relations were observed between GSH-Px, GSH, CAT, ALA-D activity and B-Hg or H-Hg (p<0.05). ALA-D reactivation index was positively related to B-Hg (p<0.0001). P-Hg was directly related to ALA-D reactivation index and inversely associated with GSH-Px, GSH, and ALA-D activity (p<0.05). When stratified for gender, women showed significant inverse associations between all biomarkers of Hg exposure and CAT (p<0.05) or GSH (p<0.05), while for men only P-Hg showed a significant inverse relation with GSH (p<0.001). Our results clearly demonstrated an association between Hg exposure and oxidative stress. Moreover, for B-Hg, P-Hg and H-Hg gender differences were present.

Long-term exposure to methylmercury and its effects on hypertension in Minamata

Recent studies suggest potential adverse effects of methylmercury exposure on cardiovascular disease, although the evidence of association with hypertension is still inconsistent. Therefore, we evaluated the effects of methylmercury exposure on hypertension in Minamata. We used data derived from the 1971 population-based survey in Minamata and neighboring communities. We also utilized data on hair mercury content of the participants (derived from a 1960 investigation). We adopted two exposure indices (residential area and hair mercury content) and two hypertension outcomes (past history of hypertension and hypertension defined by measurements in the examination). Then, we estimated the adjusted prevalence odds ratio (POR) and its confidence interval (CI) of both hypertension outcomes in relation to residential area and hair mercury content. In the Minamata area (high exposure area), 87% (833) of the eligible population (aged > or =10 years) participated in the 1971 investigations. In the Goshonoura area (middle exposure area) and the Ariake area (low exposure area), 93% (1450) and 77% (755), respectively, of the eligible population participated. Compared with subjects in the Ariake area, the subjects in the Minamata area manifested hypertension more frequently, and PORs observed for two hypertension outcomes were 1.6 (95% CI: 1.2-2.1) and 1.4 (95% CI: 1.1-1.9), respectively. Furthermore, dose-response trends with hair mercury content were observed for both hypertension outcomes. The present finding supports the causal relationship between methylmercury exposure and hypertension.

Environmental exposure to methylmercury is associated with a decrease in nitric oxide production

Some studies have recently suggested that mercury (Hg)-exposed populations face increased risks of cardiovascular diseases, and experimental data indicate that such risks might be due to reductions in nitric oxide bioavailability. However, no previous study has examined whether Hg exposure affects plasma nitrite concentrations in humans as an indication of nitric oxide production. Here, we investigated whether there is an association between circulating nitrite and Hg concentrations in whole blood, plasma and hair from an exposed methylmercury (MeHg) population. Hair and blood samples were collected from 238 persons exposed to MeHg from fish consumption. Hg concentrations in plasma (PHg), whole blood (BHg) and hair Hg (HHg) were determined by inductively coupled plasma-mass spectrometry. Mean BHg content was 49.8 +/- 35.2 microg/l, mean PHg was 7.8 +/- 6.9 microg/l and HHg 14.6 +/- 10.6 microg/g. Mean plasma nitrite concentration was 253.2 +/- 105.5 nM. No association was found between plasma nitrite concentration and BHg or HHg concentrations in a univariate model. However, multiple regression models adjusted for gender, age and fish consumption showed a significant association between plasma nitrite and plasma Hg concentration (beta = -0.1, p < 0.001). Our findings constitute preliminary clinical evidence that exposure to MeHg may cause inhibitory effects on the production of endothelial nitric oxide.

Hair mercury levels in Amazonian populations: spatial distribution and trends

BACKGROUND

Mercury is present in the Amazonian aquatic environments from both natural and anthropogenic sources. As a consequence, many riverside populations are exposed to methylmercury, a highly toxic organic form of mercury, because of their intense fish consumption. Many studies have analysed this exposure from different approaches since the early nineties. This review aims to systematize the information in spatial distribution, comparing hair mercury levels by studied population and Amazonian river basin, looking for exposure trends.

METHODS

The reviewed papers were selected from scientific databases and online libraries. We included studies with a direct measure of hair mercury concentrations in a sample size larger than 10 people, without considering the objectives, approach of the study or mercury speciation. The results are presented in tables and maps by river basin, displaying hair mercury levels and specifying the studied population and health impact, if any.

RESULTS

The majority of the studies have been carried out in communities from the central Amazonian regions, particularly on the Tapajós River basin. The results seem quite variable; hair mercury means range from 1.1 to 34.2 microg/g. Most studies did not show any significant difference in hair mercury levels by gender or age. Overall, authors emphasized fish consumption frequency as the main risk factor of exposure. The most studied adverse health effect is by far the neurological performance, especially motricity. However, it is not possible to conclude on the relation between hair mercury levels and health impact in the Amazonian situation because of the relatively small number of studies.

CONCLUSIONS

Hair mercury levels in the Amazonian regions seem to be very heterogenic, depending on several factors. There is no obvious spatial trend and there are many areas that have never been studied. Taking into account the low mercury levels currently handled as acceptable, the majority of the Amazonian populations can be considered exposed to methylmercury contamination. The situation for many of these traditional communities is very complex because of their high dependence on fish nutrients. It remains difficult to conclude on the Public Health implication of mercury exposure in this context.

Sub-chronic exposure to methylmercury at low levels decreases butyrylcholinesterase activity in rats

In this study, we examined the effects of low levels and sub-chronic exposure to methylmercury (MeHg) on butyrylcholinesterase (BuChE) activity in rats. Moreover, we examined the relationship between BuChE activity and oxidative stress biomarkers [delta-aminolevulinic acid dehydratase (delta-ALA-D) and malondialdehyde levels (MDA)] in the same animals. Rats were separated into three groups (eight animals per group): (Group I) received water by gavage; (Group II) received MeHg (30 microg/kg/day) by gavage; (Group III) received MeHg (100 microg/kg/day). The time of exposure was 90 days. BuChE and ALA-D activities were measured in serum and blood, respectively; whereas MDA levels were measured in plasma. We found BuChE and ALA-D activities decreased in groups II and III compared to the control group. Moreover, we found an interesting negative correlation between plasmatic BuChE activity and MDA (r = -0.85; p < 0.01) and a positive correlation between plasmatic BuChE activity and ALA-D activities (r = 0.78; p < 0.01), thus suggesting a possible relationship between oxidative damage promoted by MeHg exposure and the decrease of BuChE activity. In conclusion, long-term exposure to low doses of MeHg decreases plasmatic BuChE activity. Moreover, the decrease in the enzyme is strongly correlated with the oxidative stress promoted by the metal exposure. This preliminary finding highlights a possible mechanism for MeHg to reduce BuChE activity in plasma. Additionally, this enzyme could be an auxiliary biomarker on the evaluation of MeHg exposure.

Mercury exposure in a high fish eating Bolivian Amazonian population with intense small-scale gold-mining activities

Methylmercury exposure in Amazonian communities through fish consumption has been widely documented in Brazil. There is still a lack of data in other Amazonian countries, which is why we conducted this study in the Bolivian Amazon basin. Simple random sampling was used from a small village located in the lower Beni River, where there is intense gold mining and high fish consumption. All participants were interviewed and hair samples were taken to measure total mercury concentrations. The hair mercury geometric mean in the general population was 3.02 microg/g (CI: 2.69-3.37; range: 0.42-15.65). Age and gender were not directly associated with mercury levels. Fish consumption showed a positive relation and so did occupation, especially small-scale gold mining. Hair mercury levels were lower than those found in Brazilian studies, but still higher than in non-exposed populations. It is necessary to assess mercury exposure in the Amazonian regions where data is still lacking, using a standardized indicator.

Early Hg mobility in cultivated tropical soils one year after slash-and-burn of the primary forest, in the Brazilian Amazon

In the Brazilian Amazon, forest conversion to agricultural lands (slash-and-burn cultivation) contributes to soil mercury (Hg) release and to aquatic ecosystem contamination. Recent studies have shown that soil Hg loss occurs rapidly after deforestation, suggesting that Hg mobility could be related to the massive cation input resulting from biomass burning. The objective of this research was to determine the effects of the first year of slash-and-burn agriculture on soil Hg levels at the regional scale of the Tapajós River, in the state of Pará, Brazilian Amazon. A total of 429 soil samples were collected in 26 farms of five riparian communities of the Tapajós basin. In September 2004, soil samples were collected from primary forest sites planned for slash-and-burn cultivation. In August 2005, one year after the initial burning, a second campaign was held and the exact same sites were re-sampled. Our results showed that total Hg levels in soils did not change significantly during the first year following slash-and-burn, suggesting no immediate release of soil Hg at that point in time. However, an early Hg mobility was detected near the surface (0-5 cm), reflected by a significant shift in Hg distribution in soil fractions. Indeed, a transfer of Hg from fine to coarser soil particles was observed, indicating that chemical bonds between Hg and fine particles could have been altered. A correspondence analysis (CA) showed that this process could be linked to a chemical competition caused by cation enrichment. The regional dimension of the study highlighted the prevailing importance of soil types in Hg dynamics, as shown by differentiated soil responses following deforestation according to soil texture. Confirming an early Hg mobility and indicating an eventual Hg release out of the soil, our results reinforce the call for the development of more sustainable agricultural practices in the Amazon.

Fish, mercury, selenium and cardiovascular risk: current evidence and unanswered questions

Controversy has arisen among the public and in the media regarding the health effects of fish intake in adults. Substantial evidence indicates that fish consumption reduces coronary heart disease mortality, the leading cause of death in developed and most developing nations. Conversely, concerns have grown regarding potential effects of exposure to mercury found in some fish. Seafood species are also rich in selenium, an essential trace element that may protect against both cardiovascular disease and toxic effects of mercury. Such protective effects would have direct implications for recommendations regarding optimal selenium intake and for assessing the potential impact of mercury exposure from fish intake in different populations. Because fish consumption appears to have important health benefits in adults, elucidating the relationships between fish intake, mercury and selenium exposure, and health risk is of considerable scientific and public health relevance. The evidence for health effects of fish consumption in adults is reviewed, focusing on the strength and consistency of evidence and relative magnitudes of effects of omega-3 fatty acids, mercury, and selenium. Given the preponderance of evidence, the focus is on cardiovascular effects, but other potential health effects, as well as potential effects of polychlorinated biphenyls and dioxins in fish, are also briefly reviewed. The relevant current unanswered questions and directions of further research are summarized.

Human mercury exposure and adverse health effects in the Amazon: a review

This paper examines issues of human mercury (Hg) exposure and adverse health effects throughout the Amazon region. An extensive review was conducted using bibliographic indexes as well as secondary sources. There are several sources of Hg (mining, deforestation, reservoirs), and exposure takes place through inhalation or from fish consumption. There is a wide range of exposure, with mean hair-Hg levels above 15 microg/g in several Amazonian communities, placing them among the highest reported levels in the world today. Dietary Hg intake has been estimated in the vicinity of 1-2 microg/kg/day, considerably higher than the USEPA RfD of 0.1 microg/kg/day or the World Health Organization recommendation of 0.23 microg/kg/day. Neurobehavioral deficits and, in some cases, clinical signs have been reported both for adults and children in relation to Hg exposure in several Amazonian countries. There is also some evidence of cytogenetic damage, immune alterations, and cardiovascular toxicity. Since fish provide a highly nutritious food source, there is an urgent need to find realistic and feasible solutions that will reduce exposure and toxic risk, while maintaining healthy traditional dietary habits and preserving this unique biodiversity.

Mercúrio total em músculo de cação Prionace glauca (Linnaeus, 1758) e de espadarte Xiphias gladius Linnaeus, 1758, na costa sul-sudeste do Brasil e suas implicações para a saúde pública

Foram analisadas as concentrações de mercúrio total (THg) em tecido muscular do tubarão azul Prionace glauca e do teleósteo Xiphias gladius, vulgarmente conhecido como espadarte, provenientes das regiões sul e sudeste da costa brasileira, para verificar se estas se encontram dentro dos padrões legais para consumo humano. As amostras foram obtidas utilizando-se o programa REVIZEE, de agosto a setembro de 2001, e por intermédio de uma empresa de pesca em Itajaí, Santa Catarina. Foi analisado um total de 95 espécimes, testando-se as correlações entre THg, comprimento (cm) e peso (kg). As concentrações de mercúrio total em todas as amostras variaram de 0,13 a 2,26µgg-1 (peso úmido). A média de mercúrio total em P. glauca foi de 0,76 ± 0,48µgg-1 (p.u.), e em X. gladius foi de 0,62 ± 0,31µgg-1 (p.u.) com diferença não significativa (teste Mann-Whitney, p < 0,05). Em cerca de 16% das amostras, o THg excedeu o limite de 1µgg-1 (Agência Nacional de Vigilância Sanitária) e em 62% excedeu o limite de 0,5µgg-1 (Organização Mundial da Saúde - OMS). O consumo regular (100 g.dia-1) de P. glauca e de X. gladius resultaria em uma ingestão diária de THg que excederia em mais de duas vezes o limite diário de ingestão recomendado pela OMS.

Persistent, bioaccumulative and toxic substances in fish: human health considerations

Fish are important dietary items that provide essential nutrients. Fish however, bioaccumulate monomethyl mercury (MMHg) and organo-halogenated pollutants (OHP) that are persistent bioaccumulative and toxic substances (PBTS). Unlike man-made OHP, MMHg is mainly of natural origin but background concentrations of aquatic systems are determined by the environmental Hg-methylating potential. Industrial activities can modulate environmental discharges and fish bioaccumulation of PBTS. Fish and seafood consumption are associated with human body load of PBTS, but farming practices that utilize fishmeal increase the terrestrial food chain resulting in farm-animal accumulation of PBTS. These substances are neurotoxic and endocrine active that can impact humans and wild life, but chemical characteristics of MMHg and OHP modulate interactions with animal tissues. MMHg is protein reactive with a faster metabolism (months) than OHP that are stored and slowly (years) metabolized in fat tissues. Except for brain-Hg, neither Hg nor OHP in tissues are markers of toxic effects; however, deficits in neurobehavioral test-scores of children have been shown in some fish-eating populations. These deficits are transient and within normal range, and are not prodromes of neurological diseases. Although population studies show that consumption of fish at current levels of contamination do not explain neurological disorders, endocrine activity remains controversial. Understanding risk of hazard caused by fish-PBTS consumption requires a wide range of expertise. We discuss chemical, toxic, metabolic, and ecological characteristics associated with PBTS in fish. There are proven health outcome derived from fish consumption, while risk of exposure to avoidable PBTS is a chance that can be minimized by societal actions.

Cardiac autonomic activity and blood pressure among Nunavik Inuit adults exposed to environmental mercury: a cross-sectional study

BACKGROUND

Mercury is a contaminant that reaches high levels in Nunavik (North of Quebec). It is transformed into methylmercury (MeHg) and accumulated in marine mammals and predator fish, an important part of the traditional Inuit diet. MeHg has been suggested to affect BP in adults and children while the influence on HRV has only been studied in children. We aimed to assess the impact of MeHg levels on HRV and BP in Inuit adults from Nunavik.

METHODS

In the fall of 2004, the <<Qanuippitaa?>> Health Survey was conducted in Nunavik (Quebec, Canada) and information on HRV was collected among 280 adults aged 40 years and older. Indicators of the time and frequency domains of HRV were derived from a 2-hour Holter recording. BP was measured according to the Canadian Coalition for High Blood Pressure technique. Pulse pressure (PP) was the difference between systolic (SBP) and diastolic blood pressure (DBP). Blood mercury concentration was used as exposure biomarker. Statistical analysis was conducted through linear regression and multivariable linear regression was used to control for confounders.

RESULTS

Mercury was negatively correlated with low frequency (LF) (r = -0.18; p = 0.02), the standard deviation of RR intervals (SDNN) (r = -0.14; p = 0.047) and the coefficient of variation of RR intervals (CVRR) (r = -0.18; p = 0.011) while correlations with other HRV parameters did not reach statistical significance. After adjusting for confounders, the association with LF (beta = -0.006; p = 0.93) became non significant. However, the association with SDANN became statistically significant (beta = -0.086; p = 0.026) and CVRR tended to decrease with blood mercury concentrations (beta = -0.057; p = 0.056). Mercury was positively correlated with SBP (r = 0.25; p < 0.0001) and PP (r = 0.33; p < 0.0001). After adjusting for confounders, these associations remained statistically significant (beta SBP = 4.77; p = 0.01 and beta PP = 3.40; p = 0.0036). Moreover, most of the HRV parameters correlated well with BP although SBP the best before adjustment for mercury exposure.

CONCLUSION

The results of this study suggest a deleterious impact of mercury on BP and HRV in adults. SBP and PP increased with blood mercury concentrations while SDANN decreased with blood mercury concentrations.

Daily mercury intake in fish-eating populations in the Brazilian Amazon

Although high levels of fish consumption and bioindicators of mercury exposure have been reported for traditional populations in the Amazon, little is known about their actual daily intake of Hg. Using an ecosystem approach, calculate daily mercury intake in adult fish-eaters, examine the relations between mercury intake and bioindicators of exposure and the factors that influence these relations. A cross-sectional dietary survey on fish and fruit consumption frequency was carried out with 256 persons from six villages of the Tapajós River. Fish portion per meal was determined. Mercury concentration was determined for 1123 local fish specimens. Daily mercury intake (microg/kg/day) was determined for men and women from each village using the average fish-mercury concentration for the fish caught in their fishing zone, the average quantity of fish per meal, fish-species frequency consumption and participants' body weight. Fish-mercury averaged 0.33 microg/g+/-0.33. Daily mercury intake varied between 0 and 11.8 microg/kg/day (mean 0.92 microg/kg/day+/-0.89) and varied by gender and village. Mean blood- and hair-mercury were 58.7+/-36.1 microg/l and 17.9+/-11.5 microg/g, respectively. There was a strong and positive relation between blood-mercury and daily mercury intake, with an inverse relation for fruit intake and schooling; significant variations were observed with immigrant status, and among villages. Hair-mercury was directly associated with daily mercury intake and inversely related to schooling and fruit consumption. Fruit consumption modified the relation between daily mercury intake and blood-mercury levels: for the same daily mercury intake, persons eating more fruit had lower blood-mercury concentrations (ANCOVA Interaction term: F=10.9, P<0.0001). The median difference of the ratio of blood-mercury to daily mercury intake between low and high fruit consumers was 26, representing a 26.3% reduction. These findings reveal high levels of daily mercury intake. Rigorous studies for developing risk-based reference doses in the Amazon should be undertaken to orient viable risk-management strategies to reduce exposure, while maintaining fish diet.

Epidemiologic confirmation that fruit consumption influences mercury exposure in riparian communities in the Brazilian Amazon

Since deforestation has recently been associated with increased mercury load in the Amazon, the problem of mercury exposure is now much more widespread than initially thought. A previous exploratory study suggested that fruit consumption may reduce mercury exposure. The objectives of the study were to determine the effects of fruit consumption on the relation between fish consumption and bioindicators of mercury (Hg) exposure in Amazonian fish-eating communities. A cross-sectional dietary survey based on a 7-day recall of fish and fruit consumption frequency was conducted within 13 riparian communities from the Tapajós River, Brazilian Amazon. Hair samples were collected from 449 persons, and blood samples were collected from a subset of 225, for total and inorganic mercury determination by atomic absorption spectrometry. On average, participants consumed 6.6 fish meals/week and ate 11 fruits/week. The average blood Hg (BHg) was 57.1 +/- 36.3 microg/L (median: 55.1 microg/L), and the average hair-Hg (HHg) was 16.8 +/- 10.3 microg/g (median: 15.7 microg/g). There was a positive relation between fish consumption and BHg (r = 0.48; P<0.0001), as well as HHg (r =0.34; P<0.0001). Both fish and fruit consumption entered significantly in multivariate models explaining BHg (fish: beta = 5.6, P<0.0001; fruit: beta = -0.5, P = 0.0011; adjusted model R2 = 36.0%) and HHg levels (fish: beta = 1.2, P<0.0001; fruit: beta = -0.2, P = 0.0002; adjusted model R2 = 21.0%). ANCOVA models showed that for the same number of fish meals, persons consuming fruits more frequently had significantly lower blood and HHg concentrations. For low fruit consumers, each fish meal contributed 9.8 microg/L Hg increase in blood compared to only 3.3 microg/L Hg increase for the high fruit consumers. In conclusion, fruit consumption may provide a protective effect for Hg exposure in Amazonian riparians. Prevention strategies that seek to maintain fish consumption while reducing Hg exposure in fish-eating communities should be pursued.