Neurotoxic sequelae of mercury exposure: an intervention and follow-up study in the Brazilian Amazon

Mercury intoxication and ophthalmic involvement: An update review

Human intoxication after mercury exposure is a rare condition that can cause severe damage to the central nervous, respiratory, cardiovascular, renal, gastrointestinal, skin, and visual systems and represents a major public health concern. Ophthalmic involvement includes impaired function of the extraocular muscles and the eyelids, as well as structural changes in the ocular surface, lens, retina, and optic nerve causing a potential irreversible damage to the visual system. Although, there are many pathways for poisoning depending on the mercury form, it has been suggested that tissue distribution does not differ in experimental animals when administered as mercury vapor, organic mercury, or inorganic mercury. Additionally, visual function alterations regarding central visual acuity, color discrimination, contrast sensitivity, visual field and electroretinogram responses have also been described widely. Nevertheless, there is still controversy about whether visual manifestations occur secondary to brain damage or as a direct affectation, and which ocular structure is primarily affected. Despite the use of some imaging techniques such as in vivo confocal microscopy of the cornea, optical coherence tomography (OCT) of the retina and optic nerve, and functional tests such as electroretinography has helped to solve in part this debate, further studies incorporating other imaging modalities such as autofluorescence, OCT angiography or adaptive optics retinal imaging are needed. This review aims to summarize the published structural and functional alterations found in the visual system of patients suffering from mercury intoxication.

Visual Characteristics of Adults with Long-Standing History of Dietary Exposure to Mercury in Grassy Narrows First Nation, Canada

Since the 1960s, Grassy Narrows First Nation (Ontario, Canada) has been exposed to methyl mercury (Hg) through fish consumption, resulting from industrial pollution of their territorial waters. This cross-sectional study describes the visual characteristics of adults with documented Hg exposure between 1970 and 1997. Oculo-visual examinations of 80 community members included visual acuity, automated visual fields, optical coherence tomography [OCT], color vision and contrast sensitivity. Median age was 57 years (IQR 51-63) and 55% of participants were women. Median visual acuity was 0.1 logMAR (Snellen 6/6.4; IQR 0-0.2). A total of 26% of participants presented a Visual Field Index inferior to 62%, and qualitative losses assessment showed concentric constriction (18%), end-stage concentric loss (18%), and complex defects (24%). On OCT, retinal nerve fiber layer scans showed 74% of participants within normal/green range. For color testing with the Hardy, Rand, and Rittler test, 40% presented at least one type of color defect, and with the Lanthony D-15 test, median color confusion index was 1.59 (IQR 1.33-1.96). Contrast sensitivity showed moderate loss for 83% of participants. These findings demonstrate important loss of visual field, color vision, and contrast sensitivity in older adults in a context of long-term exposure to Hg in Grassy Narrows First Nation.

Neurological Impacts of Chronic Methylmercury Exposure in Munduruku Indigenous Adults: Somatosensory, Motor, and Cognitive Abnormalities

There has been increasing evidence about mercury (Hg) contamination in traditional populations from the Amazon Basin due to illegal gold mining. The most concerning health impact is neurotoxicity caused by Hg in its organic form: methylmercury (MeHg). However, the severity and extent of the neurotoxic effects resulting from chronic environmental exposure to MeHg are still unclear. We conducted a clinical-epidemiological study to evaluate the neurological impacts of chronic MeHg exposure in Munduruku indigenous people, focusing on somatosensory, motor, and cognitive abnormalities. All participants were subjected to a systemized neurological exam protocol, including Brief Cognitive Screening Battery (BCSB), verbal fluency test, and Stick Design Test. After the examination, hair samples were collected to determine MeHg levels. Data collection took place between 29 October and 9 November 2019, in three villages (Sawré Muybu, Poxo Muybu, and Sawré Aboy) from Sawré Muybu Indigenous Land, Southwest of Pará state. One hundred and ten individuals >12 years old were included, 58 of which were men (52.7%), with an average age of 27.6 years (range from 12 to 72). Participants’ median MeHg level was 7.4 µg/g (average: 8.7; S.D: 4.5; range: 2.0–22.8). In Sawré Aboy village, the median MeHg level was higher (12.5 µg/g) than in the others, showing a significant statistical exposure gradient (Kruskal–Wallis test with p-value < 0.001). Cerebellar ataxia was observed in two participants with MeHg levels of 11.68 and 15.68 µg/g. Individuals with MeHg exposure level ≥10 µg/g presented around two-fold higher chances of cognitive deficits (RP: 2.2; CI 95%: 1.13–4.26) in BCSB, and in the verbal fluency test (RP: 2.0; CI 95%: 1.18–3.35). Furthermore, adolescents of 12 to 19 years presented three-fold higher chances of verbal development deficits, according to the fluency test (RP: 3.2; CI 95%: 1.06–9.42), than individuals of 20 to 24 years. The worsened motor and cognitive functions are suggestive of neurotoxicity due to chronic MeHg exposure. In conclusion, we believe monitoring and follow-up measures are necessary for chronic mercury exposed vulnerable people, and a basic care protocol should be established for contaminated people in the Brazilian Unified Health System.

Human neurotoxicity of mercury in the Amazon: A scoping review with insights and critical considerations

Human exposure to mercury is a major public health concern, causing neurological outcomes such as motor and visual impairment and learning disabilities. Currently, human exposure in the Amazon is among the highest in the world. A recent systematic review (doi:10.1016/j.jtemb.2018.12.001), however, highlighted the lack of high-quality studies on mercury-associated neurotoxicity. There is, therefore, a need to improve research and much to still learn about how exposure correlates with disease. In this review, we discuss studies evaluating the associations between neurological disturbances and mercury body burden in Amazonian populations, to generate recommendations for future studies. A systematic search was performed during July 2020, in Pubmed/Medline, SCOPUS and SCIELO databases with the terms (mercury*) and (Amazon*). Four inclusion criteria were used: original article (1), with Amazonian populations (2), quantifying exposure (mercury levels) (3), and evaluating neurological outcomes (4). The extracted data included characteristics (as year or origin of authorship) and details of the research (as locations and type of participants or mercury levels and neurological assessments). Thirty-four studies, most concentrated within three main river basins (Tapajós, Tocantins, and Madeira) and related to environmental exposure, were found. Mercury body burden was two to ten times higher than recommended and main neurological findings were cognitive, vision, motor, somatosensory and emotional deficits. Important insights are described that support novel approaches to researching mercury exposure and intoxication, as well as prevention and intervention strategies. As a signatory country to the Minamata Convention, Brazil has the opportunity to play a central role in improving human health and leading the research on mercury intoxication.

Rural development and shifts in household dietary practices from 1999 to 2010 in the Tapajós River region, Brazilian Amazon: empirical evidence from dietary surveys

BACKGROUND

Research on changing dietary practices is rare in lower and middle income countries, and understanding the impact of global economic processes on population health and nutrition is important, especially of rural communities. We analyzed the diet of 22 families in Brasília Legal, a riverside community in the Tapajós River region of the Brazilian Amazon, using nonparametric tests to compare dietary surveys taken in 1999 and 2010.

RESULTS

Data from the two surveys show that food obtained through commercial supply chains became more frequent in household diets, corresponding to significant increases in daily consumption of food items rich in energy, protein, and sugar. At the same time, there was a decline in traditional Amazonian food intake.

CONCLUSIONS

Comparing these results with household socio-economic characteristics and drawing on open-ended interviews, we consider the multiple influences that economic development processes may have had on local diets. The introduction of new income sources and employment opportunities, infrastructural and transportation expansion, as well as environmental change appear to have influenced the observed dietary shifts. Such shifts are likely to have important implications for the nutritional status of communities in the Amazon, highlighting concerning trade-offs between current development trajectories and human health. Public policies and health education programs must urgently consider the interactions between sustainable development priorities in order to address emerging health risks in this rapidly changing region.

Comparison of Visual Functions of Two Amazonian Populations: Possible Consequences of Different Mercury Exposure

The present study investigated the visual perimetry and color vision of two Amazonian populations differently exposed to mercury. Ten riverines environmentally exposed to mercury by fish eating and 34 gold-miners occupationally exposed to mercury vapor. The visual perimetry was estimated using the Förster perimeter and the color vision was evaluated using a computerized version of Farnsworth-Munsell test. Riverine and gold-miners' hair mercury concentrations were quantified. Mercury hair concentration of the riverines was significantly higher than that from gold-miners. Riverines had lower perimetric area than the gold-miners. The errors in the hue ordering test of both Amazonian populations were larger than the controls (non-exposed subjects), but there was no difference between themselves. Riverines had significant multiple association between the visual function and hair mercury concentration, while the gold-miners has no significant association with the exposure. We concluded that the different ways of mercury exposure led to similar visual outcomes, with greater impairment in riverines (organic mercury exposed subjects).

Methylmercury intoxication and cortical ischemia: Pre-clinical study of their comorbidity

Stroke is one of the main causes of human disability worldwide. Ischemic stroke is mostly characterized by metabolic collapse and fast tissue damage, followed by secondary damage in adjacent regions not previously affected. Heavy metals intoxication can be associated with stroke incidence, because of their damaging action in the vascular system. Mercury, in particular, possesses a high tropism by metabolically active regions, such as the brain. In the present study we sought to evaluate whether methylmercury (MeHg) intoxication can aggravate the tissue damage caused by an ischemic stroke induced by microinjections of endothelin-1 (ET-1) into the motor cortex of adult rats. Following MeHg intoxication by gavage (0.04 mg/kg/day) during 60 days, the animals were injected with ET-1 (1 μl, 40 pmol/μl) or vehicle (1 μl). After 7 days, all animals were submitted to behavioral tests and then their brains were processed to biochemical and immunohistochemical analyses. We observed that long-term MeHg intoxication promoted a significant Hg deposits in the motor cortex, with concomitant increase of microglial response, followed by reduction of the neuronal population following ischemia and MeHg intoxication, as well as disturbance in the antioxidant defense mechanisms by misbalance of oxidative biochemistry with increase of both lipid peroxidation and nitrite levels, associated to behavioral deficits. MeHg exposure and cortical ischemia demonstrated that both injuries are able of causing significant neurobehavioural impairments in motor coordination and learning accompanied of an exacerbated microglial activation, oxidative stress and neuronal loss in the motor cortex, indicating that MeHg as a source of metabolic disturbance can act as an important increasing factor of ischemic events in the brain.

Low doses of methylmercury exposure during adulthood in rats display oxidative stress, neurodegeneration in the motor cortex and lead to impairment of motor skills

Despite the vast distribution among tissues, the central nervous system (CNS) represents the main target of methylmercury (MeHg) toxicity. However, few studies have evaluated the effects of MeHg exposure on the CNS at equivalent doses to human environmental exposure. In our study, we evaluated the motor cortex, an important area of motor control, in adult rats chronically exposed to MeHg in a concentration equivalent to those found in fish-eating populations exposed to mercury (Hg). The parameters evaluated were total Hg accumulation, oxidative stress, tissue damage, and behavioral assessment in functional actions that involved this cortical region. Our results show in exposed animals a significantly greater level of Hg in the motor cortex; increase of nitrite levels and lipid peroxidation, associated with decreased antioxidant capacity against peroxyl radicals; reduction of neuronal and astrocyte density; and poor coordination and motor learning impairment. Our data showed that chronic exposure at low doses to MeHg is capable of promoting damages to the motor cortex of adult animals, with changes in oxidative biochemistry misbalance, neurodegeneration, and motor function impairment.

Assessing mercury intoxication in isolated/remote populations: Increased S100B mRNA in blood in exposed riverine inhabitants of the Amazon

Mercury is a heavy metal responsible for human intoxication worldwide and especially in the Amazon, where both natural and anthropogenic sources are responsible for exposure in riverine populations. Methylmercury is the most toxic specie of mercury with recognized neurotoxicity due to its affinity for the central nervous system. S100B protein is a well-established biomarker of brain damage and it was recently associated with mercury-related neurotoxicity. Accurate measurement is especially challenging in isolated/remote populations due to the difficulty of adequate sample conservation, therefore here we use S100B mRNA levels in blood as a way to assay mercury neurotoxicity. We hypothesized that individuals from chronically exposed populations showing mercury levels above the limit of 10 μg/g in hair would present increased levels of S100B mRNA, likely due to early brain damage. A total of 224 riverine individuals were evaluated for anthropometric data (age, body mass index), self-reported symptoms of mercury intoxication, c-reactive protein in blood, and mercury speciation in hair. Approximately 20% of participants showed mercury levels above the limit, and prevalence for most symptoms was not different between individuals exposed to high or low mercury levels. Rigorous exclusion criteria were applied to avoid confounding factors and S100B mRNA in blood was tested by RT-qPCR. Participants with ≥10 μg/g of mercury had S100B mRNA levels over two times higher than that of individuals with lower exposure. A significant correlation was also detected between mercury content in hair and S100B mRNA levels in blood, supporting the use of the latter as a possible candidate to predict mercury-induced neurotoxicity. This is the first report of an association between S100B mRNA and mercury exposure in humans. The combination of both exposure and intoxication biomarkers could provide additional support for the screening and early identification of high-risk individuals in isolated populations and subsequent referral to specialized centers.

Unravelling motor behaviour hallmarks in intoxicated adolescents: methylmercury subtoxic-dose exposure and binge ethanol intake paradigm in rats

Methylmercury (MeHg) is a hazardous environmental pollutant, affecting Amazon basin communities by anthropogenic activities. The exact safe level of MeHg exposure is unclear, despite the efforts of health international societies to avoid mercury (Hg) poisoning. Central nervous system is severely impacted by Hg intoxication, reflecting on motor impairment. In addition, alcohol has been associated to an overall brain damage. According to lifestyle of Amazon riverside communities, alcohol intake occurs frequently. Thus, we investigated if continuous MeHg exposure at low doses during adolescence displays motor deficits (experiment 1). In the experiment 2, we examine if the co-intoxication (i.e. MeHg plus ethanol exposure) during adolescence intensify motor damage. In the experiment 1, Wistar adolescent rats (31 days old) received chronic exposure to low dose (CELD) of MeHg (40 μg/kg/day) for 35 days. For the experiment 2, five sessions of alcohol binge drinking paradigm (3ON-4OFF; 3.0 g/kg/day) were employed associated to MeHg intoxication. Motor behaviour was evaluated by the open field, pole test, beam walking and rotarod paradigms. CELDS of MeHg display motor function damage, related to hypoactivity, bradykinesia-like behaviour, coordination deficits and motor learning impairment. Co-intoxication of MeHg plus ethanol reduced cerebellar Hg content, however also resulted in motor behavioural impairment, as well as additive effects on bradykinesia and fine motor evaluation.

Genetic Susceptibility to Neurodegeneration in Amazon: Apolipoprotein E Genotyping in Vulnerable Populations Exposed to Mercury

Human exposure to mercury is a serious problem of public health in Amazon. As in other vulnerable populations throughout the world, Amazonian riverine populations are chronically exposed to this metal and some symptoms of mercury intoxication were already detected in these populations. However, studies on the genetic susceptibility to mercury toxicity in the Amazon are scarce, and they tested a limited number of individuals. In this context, apolipoprotein E gene (APOE) is a key element with a well-established association among their alleles and the neurodegenerative consequences of mercury intoxication. However, no studies have addressed APOE genotyping in Amazonian exposed populations. Additionally, epidemiological studies with APOE genotyping in Amazon have been restricted to indigenous populations. Therefore, this work analyzed for the first time the genotypic and allelic profiles of APOE in Amazonian riverine populations chronically exposed to mercury. Eight hundred and twenty three individuals were enrolled in our study donating blood (794) and/or hair (757). APOE genotyping was analyzed by real-time PCR. Total mercury and mercury species were quantified by ICP-MS and GC-pyro-AFS, respectively. Genomic ancestry markers were evaluated by multiplex-PCR reaction, separated by capillary electrophoresis on the ABI 3130 Genetic Analyzer instrument and analyzed on GeneMapper ID v3.2. The 𝜀3 and 𝜀3/𝜀3 were the most frequent allele and genotype, respectively, followed by 𝜀4 allele and 𝜀3/𝜀4 genotype. Only 𝜀2/𝜀2 genotype was not found, suggesting that the absence of this genotype is a generalized phenomenon in Amazon. Also, our data supported an association between the presence of APOE4 and the Amerindian origin in these populations. Fifty-nine individuals were identified at maximum risk with levels of mercury above 10 μg/g and the presence of APOE4. Interestingly, among individuals with high mercury content, APOE4-carriers had high mercury levels than APOE2-carriers, pointing to a different heavy metal accumulation according to the APOE allele. These data suggest that APOE4, in addition to a possible pharmacodynamic effect, may influence pharmacokinetically the mercury exposure causing its higher accumulation and leading to worse deleterious consequences. Our results may aid in the development of prevention strategies and health policy decision-making regarding these at-risk vulnerable populations.

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.

Health effects associated with measured levels of contaminants in the Arctic

The Human Health Assessment Group has over the past decade recommended that effect studies be conducted in the circumpolar area. Such studies examine the association between contaminant exposure in the Arctic populations and health effects. Because foetuses and young children are the most vulnerable, effect studies are often prospective child cohort studies. The emphasis in this article is on a description of the effects associated with contaminant exposure in the Arctic. The main topics addressed are neurobehavioural, immunological, reproductive, cardiovascular, endocrine and carcinogenic effect. For each topic, the association between exposure and effects is described, and some results are reported for similar studies outside the Arctic.

Mercury levels and human health in the Amazon Basin

CONTEXT

Environmental mercury in the Amazon mostly originates from geochemical sources with some from artisanal gold mining (AGM). Geochemical-originated methylmercury (MeHg) reaches the aquatic food chain, ending up in fish. Inorganic Hg used in AGM is responsible for localised environmental contamination and occupational exposure of adults. In addition to this, iatrogenic ethylmercury (EtHg) derived from Thimerosal-containing vaccines (TCVs) exposes immunised infants.

OBJECTIVE

To understand Hg exposure in the Amazon in relation to environmental fish-MeHg exposure, occupational AGM activities and low-doses of TCV-EtHg.

METHODS

Medline and Thomson-Reuter Web of Science were searched to retrieve and select papers addressing Hg exposure and human health.

RESULTS AND CONCLUSION

Environmental-Hg studies addressed health effects associated with birth weight, infant linear growth and neurodevelopment, while, in adults, environmental and occupational studies addressed immune and neurological issues. No widespread clinical toxicity was reported due to fish-MeHg. However, mixed results associated with Hg exposure can be found. Reducing children's exposure to EtHg is possible using Thimerosal-free vaccines, but it is difficult to interfere with fish consumption without consequences to riverine subsistence populations. Policies to diminish Hg exposure should focus on controlling and/or curbing widespread use of Hg (in gold amalgamation) and promotion of Thimerosal-free vaccines for pregnant women and young children.

Diet enriched with the Amazon fruit açaí (Euterpe oleracea) prevents electrophysiological deficits and oxidative stress induced by methyl-mercury in the rat retina

BACKGROUND

The protective effect of a diet supplemented by the Amazonian fruit Euterpe oleracea (EO) against methylmercury (MeHg) toxicity in rat retina was studied using electroretinography (ERG) and biochemical evaluation of oxidative stress.

METHOD

Wistar rats were submitted to conventional diet or EO-enriched diet for 28 days. After that, each group received saline solution or 5 mg/kg/day of MeHg for 7 days. Full-field single flash, flash and flicker ERGs were evaluated in the following groups: control, EO, MeHg, and EO+MeHg. The amplitudes of the a-wave, b-wave, photopic negative response from rod and/or cone were measured by ERGs as well as the amplitudes and phases of the fundamental component of the sine-wave flicker ERG. Lipid peroxidation was determined by thiobarbituric acid reactive species.

RESULTS

All ERG components had decreased amplitudes in the MeHg group when compared with controls. EO-enriched food had no effect on the non-intoxicated animals. The intoxicated animals and those that received the supplemented diet presented significant amplitude reductions of the cone b-wave and of the fundamental flicker component when compared with non-intoxicated control. The protective effect of the diet on scotopic conditions was only observed for bright flashes eliciting a mixed rod and cone response. There was a significant increase of lipid peroxidation in the retina from animals exposed to MeHg and EO-supplemented diet was able to prevent MeHg-induced oxidative stress in retinal tissue.

CONCLUSION

These findings open up perspectives for the use of diets supplemented with EO as a protective strategy against visual damage induced by MeHg.

Somatosensory Psychophysical Losses in Inhabitants of Riverside Communities of the Tapajós River Basin, Amazon, Brazil: Exposure to Methylmercury Is Possibly Involved

The purpose of this work was to evaluate the somatosensory system of methylmercury-exposed inhabitants living in the communities of the Tapajós river basin by using psychophysical tests and to compare with measurements performed in inhabitants of the Tocantins river basin. We studied 108 subjects from Barreiras and São Luiz do Tapajós, two communities of the Tapajós river basin, State of Pará, Amazon, Brazil, aged 13–53 years old. Mercury analysis was performed in head hair samples weighting 0.1–0.2 g by using atomic absorption spectrometry. Three somatosensory psychophysical tests were performed: tactile sensation threshold, vibration sensation duration, and two-point discrimination. Semmes-Weinstein 20 monofilaments with different diameters were used to test the tactile sensation in the lower lip, right and left breasts, right and left index fingers, and right and left hallux. The threshold was the thinner monofilament perceived by the subject. Vibration sensation was investigated using a 128 Hz diapason applied to the sternum, right and left radial sides of the wrist, and right and left outer malleoli. Two trials were performed at each place. A stopwatch recorded the vibration sensation duration. The two-point discrimination test was performed using a two-point discriminator. Head hair mercury concentration was significantly higher in mercury-exposed inhabitants of Tapajós than in non-exposed inhabitants of Tocantins (p < 0.01). When all subjects were divided in two groups independently of age—mercury-exposed and non-exposed—the following results were found: tactile sensation thresholds in mercury-exposed subjects were higher than in non-exposed subjects at all body parts, except at the left chest; vibration sensation durations were shorter in mercury-exposed than in non-exposed subjects, at all locations except in the upper sternum; two-point discrimination thresholds were higher in mercury-exposed than in non-exposed subjects at all body parts. There was a weak linear correlation between tactile sensation threshold and mercury concentration in the head hair samples. No correlation was found for the other two measurements. Mercury-exposed subjects had impaired somatosensory function compared with non-exposed control subjects. Long-term mercury exposure of riverside communities in the Tapajós river basin is a possible but not a definitely proven cause for psychophysical somatosensory losses observed in their population. Additionally, the relatively simple psychophysical measures used in this work should be followed by more rigorous measures of the same population.

Sources of Mercury Exposure to Children in Low- and Middle-Income Countries

BACKGROUND

Many children in low- and middle-income countries face enhanced risks of exposure to contaminants via the environment, parental occupation, and other routes. While mercury (Hg) is a global pollutant whose transport properties allow it to have an impact even in pristine areas, the presence of significant Hg sources in the developing world can cause localized effects that are more severe than those observed in other areas.

OBJECTIVES

This paper provides a narrative review of sources of Hg exposure to people in the developing world with a particular focus on children, and presents an overview of key aspects to this important issue.

METHODS

We searched Web of Knowledge and Google Scholar using keywords including combinations of "mercury" and one or more of the following: "children," "exposure," "breast milk," "artisanal mining," "prenatal," "religion," "medicine," "dental amalgam," "chlor-alkali," "VCM," "vaccine," "e-waste," "industry," "beauty," "cosmetics," "strategies," "child labor," "costs," and "developing countries" to find peer-reviewed articles pertaining to Hg exposure in the developing world.

RESULTS

Sources of Hg exposure include mining, consumption, industrial operations, religious practices, traditional medicines, beauty products, vaccines, dental amalgams, and waste scavenging and recycling.

CONCLUSION

Children in the developing world are often subject to higher levels of Hg exposure than those living in developed countries due to the higher prevalence of Hg-intensive industrial processes and consumer products, lack of environmental regulation, and limits in mobility and food choices, among other factors. This issue can be addressed through additional research to fill in data gaps on exposure sources, establish sound and enforceable policies, and increase education and participation in affected communities. Challenges to addressing this problem include limited resources for needed equipment, training, and manpower to implement solutions.

Retinal and visual system: occupational and environmental toxicology

Occupational chemical exposure often results in sensory systems alterations that occur without other clinical signs or symptoms. Approximately 3000 chemicals are toxic to the retina and central visual system. Their dysfunction can have immediate, long-term, and delayed effects on mental health, physical health, and performance and lead to increased occupational injuries. The aims of this chapter are fourfold. First, provide references on retinal/visual system structure, function, and assessment techniques. Second, discuss the retinal features that make it especially vulnerable to toxic chemicals. Third, review the clinical and corresponding experimental data regarding retinal/visual system deficits produced by occupational toxicants: organic solvents (carbon disulfide, trichloroethylene, tetrachloroethylene, styrene, toluene, and mixtures) and metals (inorganic lead, methyl mercury, and mercury vapor). Fourth, discuss occupational and environmental toxicants as risk factors for late-onset retinal diseases and degeneration. Overall, the toxicants altered color vision, rod- and/or cone-mediated electroretinograms, visual fields, spatial contrast sensitivity, and/or retinal thickness. The findings elucidate the importance of conducting multimodal noninvasive clinical, electrophysiologic, imaging and vision testing to monitor toxicant-exposed workers for possible retinal/visual system alterations. Finally, since the retina is a window into the brain, an increased awareness and understanding of retinal/visual system dysfunction should provide additional insight into acquired neurodegenerative disorders.

[Neurological manifestations in riverine populations from areas exposed to mercury in the Brazilian Amazon]

This study evaluated current levels of mercury exposure and sensory symptoms in adults from three riverine communities in Pará State, Brazil, two of which located in the Tapajós River basin and one in the Tocantins basin. Participants in this study included 78 residents in Barreiras (Tapajós), 30 in São Luiz do Tapajós (Tapajós), and 49 in Furo do Maracujá (Tocantins). Total hair mercury concentrations were quantified by atomic absorption spectrophotometry, and neurological evaluation was conducted by routine examination. Mercury concentrations in the Tapajós communities were higher than those in the Tocantins (p < 0.01). Evaluation of neurological changes showed no significant difference between the communities in exposed areas and control areas for the changes observed by conventional neurological examination, except for gait deviation (p < 0.05). The study concludes that despite the mercury exposure levels, there was a low frequency of sensory alterations according to conventional neurological testing.

The influence of changes in lifestyle and mercury exposure in riverine populations of the Madeira River (Amazon Basin) near a hydroelectric project

In the Amazon Basin, naturally occurring methylmercury bioaccumulates in fish, which is a key source of protein consumed by riverine populations. The hydroelectric power-plant project at Santo Antônio Falls allows us to compare the Hg exposure of riverine populations sparsely distributed on both sides of the Madeira river before the area is to be flooded. From 2009 to 2011, we concluded a population survey of the area (N = 2,008; representing circa 80% of community residents) that estimated fish consumption and mercury exposure of riverine populations with different degrees of lifestyle related to fish consumption. Fish samples from the Madeira river (N = 1,615) and 110 species were analyzed for Hg. Hair-Hg was significantly lower (p < 0.001) in less isolated communities near to the capital of Porto Velho (median 2.32 ppm) than in subsistence communities in the Cuniã Lake, 180 km from Porto Velho city (median 6.3 ppm). Fish Hg concentrations ranged from 0.01 to 6.06 µg/g, depending on fish size and feeding behavior. Currently available fish in the Madeira river show a wide variability in Hg concentrations. Despite cultural similarities, riparians showed hair-Hg distribution patterns that reflect changes in fish-eating habits driven by subsistence characteristics.

Os desafios da geração do conhecimento em saúde ambiental: uma perspectiva ecossistêmica

O artigo explora as oportunidades e as limitações da geração de conhecimento no campo da saúde ambiental. Argumenta que a compreensão da complexidade dos fatores que condicionam a saúde humana e dos ecossistemas demanda redefinições na tradicional distribuição de papéis e responsabilidades na pesquisa científica. Estas práticas de pesquisa encerram enfoques inter e transdisciplinares e a aplicação de uma abordagem ecossistêmica (ecosaúde). Desafios e oportunidades da aplicação da inter e transdisciplinaridade a problemáticas de saúde ambiental são discutidos e ilustrados por meio de dois estudos de caso que utilizam uma abordagem ecosaúde: uma experiência brasileira que trata da contaminação e exposição ao mercúrio na Amazônia, e outra nepalense, sobre a transmissão urbana de equinococose. Concluímos apresentando o potencial de uma abordagem ecosaúde na superação dos limites das práticas unidisciplinares e na valorização dos saberes e da participação local.

Characterization of mercury concentrations in snow and potential sources, Shanghai, China

This work focused on quantifying the total mercury (HgT) and major ion concentrations in snow samples to understand the importance of this pathway and sources of Hg deposited in Shanghai, China. Rare snow event samples were collected at 26 sites within the city of Shanghai on February 18, 2006, January 27, 2008 and January 20, 2011. The sites were distributed among four main functional area types (i.e., industrial impacted, residential impacted, traffic impacted sites and sites in the city center). Concentrations of HgT and major soluble ions, and pH values were determined for each site. Mean HgT concentrations for all sites were 78±52 ng L(-1), 277±184 ng L(-1), 189±123 ng L(-1) in 2006, 2008 and 2011, respectively. Values were higher in Shanghai than observed in other cities including Beijing which has a smaller population and is less industrial. Principle component analysis (PCA) indicated that secondary aerosols (SO4(2-), NO3(-) and NH4(+)), and biomass combustion (K(+), CH3COO(-), and HCOO(-)) were best related to mercury concentrations in the snow in 2008 and 2011. Although HYSPLIT back trajectory modeling indicated air mass transport from areas with significant coal combustion, results indicate that anthropogenic pollution from within Shanghai was the predominant source of Hg in snow.