Source identification of human exposure to lead in nine Cree Nations from Quebec, Canada (Eeyou Istchee territory)

Avocational exposure associations with ALS risk, survival, and phenotype: A Michigan-based case-control study

INTRODUCTION

Environmental exposures strongly influence ALS risk and identification is needed to reduce ALS burden. Participation in hobbies and exercise may alter ALS risk and phenotype, warranting an assessment to understand their contribution to the ALS exposome.

METHODS

Participants with ALS and healthy controls were recruited from University of Michigan and self-completed a survey to ascertain hobbies, exercise, and avocational exposures. Exposure variables were associated with ALS risk, survival, onset segment, and onset age.

RESULTS

ALS (n = 400) and control (n = 287) participants self-reported avocational activities. Cases were slightly older (median age 63.0 vs. 61.1 years, p = 0.019) and had a lower educational attainment (p < 0.001) compared to controls; otherwise, demographics were well balanced. Risks associating with ALS after multiple comparison correction included golfing (odds ratio (OR) 3.48, padjusted = 0.004), recreational dancing (OR 2.00, padjusted = 0.040), performing gardening or yard work (OR 1.71, padjusted = 0.040) five years prior to ALS and personal (OR 1.76, padjusted = 0.047) or family (OR 2.21, padjusted = 0.040) participation in woodworking, and personal participation in hunting and shooting (OR 1.89, padjusted = 0.040). No exposures associated with ALS survival and onset. Those reporting swimming (3.86 years, padjusted = 0.016) and weightlifting (3.83 years, padjusted = 0.020) exercise 5 years prior to ALS onset had an earlier onset age.

DISCUSSION

The identified exposures in this study may represent important modifiable ALS factors that influence ALS phenotype. Thus, exposures related to hobbies and exercise should be captured in studies examining the ALS exposome.

Sources of exposure to lead in Arctic and subarctic regions: a scoping review

Understanding lead exposure pathways is a priority because of its ubiquitous presence in the environment as well as the potential health risks. We aimed to identify potential lead sources and pathways of lead exposure, including long-range transport, and the magnitude of exposure in Arctic and subarctic communities. A scoping review strategy and screening approach was used to search literature from January 2000 to December 2020. A total of 228 academic and grey literature references were synthesised. The majority of these studies (54%) were from Canada. Indigenous people in Arctic and subarctic communities in Canada had higher levels of lead than the rest of Canada. The majority of studies in all Arctic countries reported at least some individuals above the level of concern. Lead levels were influenced by a number of factors including using lead ammunition to harvest traditional food and living in close proximity to mines. Lead levels in water, soil, and sediment were generally low. Literature showed the possibility of long-range transport via migratory birds. Household lead sources included lead-based paint, dust, or tap water. This literature review will help to inform management strategies for communities, researchers, and governments, with the aim of decreasing lead exposure in northern regions.

Can common dietary assessment methods be better designed to capture the nutritional contribution of neglected, forest, and wild foods to diets?

Food systems are the primary cause of biodiversity loss globally. Biodiversity and specifically, the role that wild, forest and neglected and underutilised species (NUS) foods might play in diet quality is gaining increased attention. The narrow focus on producing affordable staples for dietary energy has contributed to largely homogenous and unhealthy diets. To date, evidence to quantify the nutritional contribution of these biodiverse foods is limited. A scoping review was conducted to document the methods used to quantify the contribution of wild, forest and NUS foods. We found 37 relevant articles from 22 different countries, mainly from Africa (45%), the Americas (19%), and Asia (10%). There were 114 different classifications used for the foods, 73% of these were specifically related to wild or forest foods. Most dietary assessments were completed using a single day qualitative or quantitative 24 h open recall (n = 23), or a food frequency questionnaire (n = 12). There were 18 different diet related indicators used, mainly nutrient adequacy (n = 9) and dietary diversity scores (n = 9). Often, no specific nutritionally validated diet metric was used. There were 16 studies that presented results (semi) quantitatively to measure the contribution of wild, forest or NUS foods to dietary intakes. Of these, 38% were aggregated together with broader classifications of 'traditional' or 'local' foods, without definitions provided meaning it was not possible to determine if or to what extend wild, forest of NUS foods were included (or not). In almost all studies there was insufficient detail on the magnitude of the associations between wild, forest or NUS foods and dietary energy or nutrient intakes or the (qualitative) diet recall methodologies that were used inhibited the quantification of the contribution of these foods to diets. A set of six recommendations are put forward to strengthen the evidence on the contribution of wild, NUS, and forest foods to human diets.

Indigenous Land-Based Approaches to Well-Being: The Niska (Goose) Harvesting Program in Subarctic Ontario, Canada

Historically, goose harvesting provided a source of culturally significant, safe, and nutritious food for the Omushkego Cree of subarctic Ontario, Canada. Disruptions stemming from colonization and climate change have led to a decrease in harvesting, resulting in higher rates of food insecurity. The aim of the Niska program was to reconnect Elders and youth to revitalize goose harvesting activities and associated Indigenous knowledge within the community. The program and evaluation were built using a two-eyed seeing (Etuaptmumk) and community-based participatory research approach. Salivary cortisol, a biomedical measure of stress, was collected before (n = 13) and after (n = 13) participation in the spring harvest. Likewise, cortisol samples were collected before (n = 12) and after (n = 12) the summer harvest. Photovoice and semi-directed interviews were employed after the spring (n = 13) and summer (n = 12) harvests to identify key elements of well-being from an Indigenous perspective. The changes observed in cortisol levels for the spring (p = 0.782) and summer (p = 0.395) harvests were not statistically significant. However, there was a noteworthy increase in the subjective well-being observed through the qualitative measures (semi-directed interviews and photovoice), highlighting the importance of using multiple perspectives when assessing well-being, especially in Indigenous peoples. Future programs should incorporate multiple perspectives when addressing complex environmental and health issues, such as food security and environmental conservation, especially in Indigenous homelands worldwide.

A probabilistic hazard and risk assessment of exposure to metals and organohalogens associated with a traditional diet in the Indigenous communities of Eeyou Istchee (northern Quebec, Canada)

Hunting, trapping, and fishing are part of an Indigenous lifestyle in subarctic Canada. However, this lifestyle may be a route of exposure to contaminants and may pose a risk for the people who rely on a subsistence diet. Monte Carlo simulations for the chemical concentration of eight game species and one fish species were carried out by randomly sampling 10,000 samples from the contaminant measures for each species. We then calculated a probabilistic non-carcinogenic hazard quotient or carcinogenic risk values to estimate the human health risk of exposure to contaminants. Of the species examined, ducks were of concern for potential carcinogenic risk. There was a modeled probabilistic 95th-percentile risk associated with the consumption of ducks and polybrominated biphenyl (PBB) congener 153 in boys, women, and men (1.09 × 10-6, 1.57 × 10-6, and 2.17 × 10-6, respectively) and, to a lesser extent, with geese and polychlorinated biphenyl (PCB) congener 153 in men (1.19 × 10-6). Contaminant concentration in the intake rate (food consumption) for PBB congener 153 exposure risk was more important than that for PCB congener 153, where intake rate had greater relevance. The consumption of waterfowl may increase the exposure to organohalogens; however, there are health and wellness benefits associated with the harvesting and consumption of subsistence foods that must also be considered. We recommend follow-up species-specific studies focused on ducks to clarify and elucidate the results in the present study.

Potential obesogenic effect of a complex contaminant mixture on Cree First Nations adults of Northern Québec, Canada

BACKGROUND

Obesity incidence and prevalence is of increasing concern in First Nations communities around Canada. In addition to diet and physical activity, environmental pollutants have been suggested as a potential contributory factor to obesity associated morbidity. Owing to the exposure of Cree First Nations people to various persistent organic pollutants (POPs) and toxic metals, it is important to examine the association between obesity in these communities, and contaminant body burdens.

OBJECTIVE

To determine whether selected morphometry measures (body mass index [BMI], waist circumference [WC] and body fat percentage) are associated with body burdens of 10 POPs and toxic metals.

METHODS

Using data from the Nituuchischaayihtitaau Aschii Multi-community Environment-and-Health study in the eastern James Bay (Eeyou Istchee) Cree communities, this cross-sectional study examined morphometric and contaminant measures of 695 eligible participants. Sex stratified principal component analysis was conducted on blood plasma concentrations of 10 POPs and toxic metals. BMI, WC, body fat percent, and resultant contaminant components were used to create generalized linear models, and adjusted for covariates (age, total lipids, smoking, and n-3 fatty acids).

RESULTS

Two principal components (PCs; PC-1 and PC-2) were extracted for both males and females. For females, PC-1 explained 73.3% and PC-2 explained 10.5%, and for males, PC-1 explained 71.6% and PC-2 explained 11.2% of the variance in contaminant burden. For both sexes, PC-1 loaded highly for polychlorinated biphenyl (PCB) congeners, organochlorine pesticides and, to a lesser extent, mercury and lead. PC-2 loaded highly for cadmium for females, and cadmium and lead for males. After adjusting for covariates, the generalized linear model showed that PC-2 was significantly and negatively associated with BMI, body fat percent, and WC in males and females.

CONCLUSIONS

Our cross-sectional analysis indicates a negative association between cadmium with various obesity measures in both males and females. Null associations were found between PCBs and organochlorine pesticides and morphometry.

Harvest Programs in First Nations of Subarctic Canada: The Benefits Go Beyond Addressing Food Security and Environmental Sustainability Issues

By breaking down barriers that impacted the ability of subarctic First Nations people to harvest waterfowl, the Sharing-the-Harvest program provided a safe, nutritious, and culturally appropriate food (i.e., geese) to James Bay Cree communities while also helping to protect the environment by harvesting overabundant geese. However, the impacts extend beyond those described above. Thus, the objectives of the present paper are twofold: to document the food sharing networks of the Sharing-the-Harvest program; and to examine the benefits associated with the harvest program beyond food security and environmental sustainability issues, as revealed through semi-directed interviews. In the regional initiative, harvested geese were shared with all James Bay communities; sharing is an important part of Cree culture. Where detailed information was collected, the goose-sharing network reached 76% of the homes in one of the communities. Likewise, in the local initiative, the goose-sharing network had a 76% coverage rate of the homes in the community. Although decreasing food insecurity was an important focus of the harvest-sharing programs, there were other benefits, from an Indigenous perspective, of being on the land, as identified by the Cree harvesters through semi-directed interviews (e.g., the transmission of Indigenous knowledge, the strengthening of social networks, and the feeling of wellness while out on-the-land). Thus, by participating in the on-the-land harvest programs, the Cree gained benefits beyond those solely related to strengthening food security and contributing in part to environmental sustainability. The Sharing-the-Harvest protocol has the potential to be adapted and employed by other Indigenous (or marginalized) groups worldwide, to help improve health and wellness, while, also protecting the environment from overabundant and/or invasive species.

Human biomonitoring of metals in sub-Arctic Dene communities of the Northwest Territories, Canada

A human biomonitoring project investigating environmental exposures to metals from hair, blood and urine samples was implemented in the Northwest Territories, Canada, between January 2016 and March 2018. This study reports the metal biomarker levels from nine Dene communities located in the Dehcho and Sahtú regions to identify contaminants of interest. Levels of metals in the urine (n = 198), blood (n = 276) and hair (n = 443) samples were generally similar to those seen in other biomonitoring studies in Canada, but lead levels in blood (GM = 16 μg/L; 95th percentile = 71 μg/L) and urine (GM = 0.59 μg/L, 0.69 μg/g of creatinine; 95th percentile = 4.2 μg/L, 4.0 μg/g of creatinine) were higher than those observed in the Canadian Health Measure Survey (CHMS, cycles 2 and 5). Hair mercury (but not blood mercury) appeared higher than observed in participants from the CHMS cycle 5. The vast majority of participants had biomarker levels below the biomonitoring guidance values established for mercury and lead. Based on a comparative analysis of biomarker statistics relative to a nationally-representative survey, metals and essential trace elements of particular interest for follow-up research include: lead, manganese, mercury, and selenium. This project provided baseline biomarker levels in participating regions, which is essential to track changes in the future, and identify the contaminants to prioritize for further investigation of exposure determinants.

Risk assessment of lead intake via food among residents in the mining areas of Nandan County, China

This study studied the dietary structure, lead (Pb) contents and exposure of the diets of the residents in the mining-affected areas of Nandan County in summer (July to August) and winter (November to December). The weighing method and the Chemical Analysis Method were applied to determine the daily intake amount of trace element Pb in the diets of the residents in the mining-affected areas and a contrast area, and subsequently estimated the Pb exposure of the diets of the residents. Based on the Provisionally Tolerable Weekly Intake (PTWI) and Margin of Exposure (MoE), the risk of Pb poisoning driven by the dietary intake of the residents in the study areas was determined. Among the food types, rice and rice products, vegetables, meat and meat products were the major contributing factors. In the mining-affected areas, Pb contents in meat and meat products ranked the top (2.47 μg/g) among the food types. The Pb contents in rice and rice products, vegetables, and meat and meat products in the mining-affected areas were significantly different from those in the contrast area. The average intake amounts of Pb in all kinds of food of the residents in the mining-affected areas (Chehe Town, Dachang Town and Zhanglao Town) were 958.6 µg/d, 1178 µg/d and 813.7 µg/d, respectively. According to the MoE method, current study confirmed high health risk due to Pb contamination in the diets of the residents in these mining-affected areas. From the dietary contribution rate perspective, meat was the main source of Pb intake of the residents in the mining-affected areas. To reduce the health risk induced by excessive Pb exposure in the dietary intake, local residents should consume more fish and grains instead of meat.

Lead Contamination in Ground Venison from Shotgun-Harvested White-Tailed Deer (Odocoileus virginianus) in Illinois

Ground venison packets from shotgun- and archery-harvested White-tailed Deer in Illinois in 2013 and 2014 were analyzed for metal contamination. Radiographs indicated that 48% of 27 ground venison packets from 10 shotgun-harvested deer contained metal fragments, while none of the 15 packets from three archery-harvested deer contained fragments. ICP-MS analysis verified that all metal fragments from seven of the venison samples from shotgun-harvested deer were composed of lead, with average concentrations from 1.04 to 8.42 μg g^-1, dry weight. A single serving of ground venison containing one of these metal fragments embedded in it would be predicted to have a lead concentration ranging from 6.4 to 51.8 μg g^-1. Sixty percent of 20 commercial meat processing plants surveyed by phone in 2018 and 2019 indicated that they mixed venison from multiple deer when preparing ground venison products. However, our results do not show any cross-contamination in archery-harvested ground venison processed prior to the firearm hunting seasons.

Health Risk Modifiers of Exposure to Persistent Pollutants among Indigenous Peoples of Chukotka

The aim of the study was to assess temporal trends in health risks related to most common persistent contaminants, including polychlorinated biphenyls (PCBs), dichloro-diphenyl-trichloroethanes (DDTs), lead (Pb), as well as mercury (Hg) among indigenous peoples living in coastal areas of Chukotka in Arctic Russia. This is examined in relation to exposure pathways and a range of social and behavioral factors capable of modifying the exposure to these contaminants, including place of residence, income, traditional subsistence, alcohol consumption, and awareness of risk prevention. The primary exposure pathway for PCBs is shown to be the intake of traditional foods, which explained as much as 90% of the total health risk calculated employing established risk guidelines. Nearly 50% of past DDT-related health risks also appear to have been contributed by contaminated indoor surfaces involving commonly used DDT-containing insecticides. Individuals who practiced traditional activities are shown to have experienced a 4.4-fold higher risk of exposure to PCBs and a 1.3-fold higher risk for DDTs, Pb, and Hg. Low income, high consumption of marine mammal fat, alcohol consumption, and lack of awareness of health risk prevention are attributed to a further 2- to 6-fold increase in the risk of PCBs exposure. Low socioeconomic status enhances the health risks associated with exposure to the persistent contaminants examined.

Examining environmental contaminant mixtures among adults with type 2 diabetes in the Cree First Nation communities of Eeyou Istchee, Canada

Type 2 diabetes mellitus (T2DM) disproportionately affects Indigenous populations. It is possible that exposure to complex mixtures of environmental contaminants contribute to T2DM development. This study examined the association between complex environmental contaminant mixtures and T2DM among Canadian Indigenous communities from the Eeyou Istchee territory, Quebec, Canada. Using data from the cross-sectional Multi-Community Environment-and-Health Study (2005–2009) Principal Component Analysis (PCA) was used to reduce the dimensionality of the following contaminants: 9-polychlorinated biphenyl congeners; 7-organic pesticides; and 4-metal/metalloids. Following this data reduction technique, we estimated T2DM prevalence ratios (PR) and 95% confidence intervals using modified Poisson regression with robust error variance across derived principal components, adjusting for a priori covariates. For both First Nation adult males (n = 303) and females (n = 419), factor loadings showed dichlorodiphenyltrichloroethane (DDT) and lead (Pb) highly loaded on the second principal component (PC) axis: DDT negatively loaded, and Pb positively loaded. T2DM was significantly associated with PC-2 across all adjusted models. Because PCA produces orthogonal axes, increasing PC-2 scores in the fully adjusted model for females and males showed (PR = 0.84; 95% CI 0.72, 0.98) and (PR = 0.78; 95% CI 0.62, 0.98), respectively. This cross-sectional study suggests that our observed association with T2DM is the result of DDT, and less likely the result of Pb exposure. Further, detectable levels of DDT among individuals may possibly contribute to disease etiology.

Essential and non-essential trace elements in fish consumed by indigenous peoples of the European Russian Arctic

In present study, the analyses of essential [copper (Cu), cobalt (Co), selenium (Se) and zinc (Zn)] and non-essential elements [mercury (Hg), lead (Pb), cadmium (Cd) and arsenic (As)] in 7 fish species consumed by the indigenous people of the European Russia Arctic were conducted. The Nenets Autonomous Region, which is located in the north-eastern part of European Russia, was chosen as a Region of interest. Within it, the Nenets indigenous group (n = 6000) constitutes approximately 10% of the total population. Nearly all of the Nenets live a traditional life with fish caught in the local waters as a subsistence resource. We found that northern pike contained twice the amount of Hg compared with roach, and 3-4 times more than other fish species commonly consumed in the Russian Arctic (namely, Arctic char, pink salmon, navaga, humpback whitefish and inconnu). Fish Hg concentrations were relatively low, but comparable to those reported in other investigations that illustrate a decreasing south-to-north trend in fish Hg concentrations. In the current study, northern pike is the only species for which Hg bioaccumulated significantly. In all fish species, both Cd and Pb were present in considerably lower concentrations than Hg. The total As concentrations observed are similar to those previously published, and it is assumed to be present primarily in non-toxic organic forms. All fish tissues were rich in the essential elements Se, Cu and Zn and, dependent on the amount fish consumed, may contribute significantly to the nutritional intake by indigenous Arctic peoples. We observed large significant differences in the molar Se/Hg ratios, which ranged from 2.3 for northern pike to 71.1 for pink salmon. Values of the latter <1 may increase the toxic potential of Hg, while those >1 appear to enhance the protection against Hg toxicity.

Rationale for the regulated transition to non-lead products in Canada: A policy discussion paper

Lead gunshot, rifle bullets, and fishing weights are still allowed in Canadian provincially-regulated hunting and fishing, despite the contribution to lead exposure in humans, wildlife, and the environment. Non-lead gunshot and fishing weights are required in Canada only for waterfowl hunting, and angling in national parks and national wildlife areas. Lead wheel weights are also allowed and comprise a majority of the Canadian market. Effective non-lead substitutes for these products exist, and are already required in various American and European jurisdictions. Several analyses commissioned by the Canadian government in 2018 identified the problems of lead exposure attributable to these four lead products. Lead is already listed under Schedule 1 of the Canadian Environmental Protection Act (CEPA) that authorizes the government to undertake measures to reduce exposure. CEPA could require, simultaneously, use of non-lead ammunition, fishing weights and wheel weights at the national level, following an appropriate phase-in period. The low provincial and territorial licence fees for hunting and fishing in Canada would offset any costs associated with use of lead substitutes. Costs for non-lead wheel weights would comprise a small percentage of the costs of new vehicles and new tire purchases. This regulatory initiative would complement other Canadian national bans on lead products. Because there is no safe threshold level for blood lead, use of non-lead products would benefit the health of humans, scavengers, upland game species, and fish-eating birds.

Factors associated with the intake of traditional foods in the Eeyou Istchee (Cree) of northern Quebec include age, speaking the Cree language and food sovereignty indicators

The Eeyouch are a First Nations (Cree) population that live above 49.6°N latitude in Eeyou Istchee in northern Quebec. Eeyouch rely on traditional foods (TF) hunted, fished or gathered from the land. The overarching aim of this study was to achieve an understanding of the factors associated with TF intake among Eeyouch. Data were from 465 women and 330 men who participated in the Nituuchischaayihtitaau Aschii Multi-Community Environment-and-Health (E&H) study. The relationship between TF consumption and dietary, health, sociodemographic and food sovereignty (i.e. being a hunter or receiving Income Security to hunt, trap or fish) variables was examined using linear and logistic regression. Analyses were stratified by sex because of the male/female discrepancy in being a hunter. Among respondents, almost all (99.7%) consumed TF, 51% were hunters and 10% received Income Security. Higher intake of TF was associated with lower consumption of less nutritious ultra-processed products (UPP). In women, TF intake increased with age, hunting and receiving Income Security, but decreased with high school education. In men, TF intake increased with age and speaking only Cree at home. The findings suggest that increased food sovereignty would result in improved diet quality among Eeyouch through increased TF intake and decreased UPP intake.

Lead Exposure in Low and Middle-Income Countries: Perspectives and Lessons on Patterns, Injustices, Economics, and Politics

Lead exposure is a legacy issue that continues to affect vulnerable population groups globally, but particularly in low and middle-income countries (LMICS). We take a multi-disciplinary approach to examine the patterns of lead exposure in these countries, discuss the underlying injustices and socio-political causes, and the economic costs that are associated with exposure. We conclude with some lessons we drew from our discussion of lead across the disciplines and advocate for a number of approaches to solving this ongoing issue. These include (i) biomonitoring that could be integrated into existing health surveys or public health programs targeting young children; (ii) greater civic engagement to push for solutions; and, (iii) environmental control policies that represent a continuum of local, context-specific to broad, national-level, and even global approaches.

Heads in the sand: public health and ecological risks of lead-based bullets for wildlife shooting in Australia

Lead (Pb) is a toxic element banned from fuel, paint and many other products in most developed countries. Nonetheless, it is still widely used in ammunition, including rifle bullets, and Pb-based bullets are almost universally used in Australia. For decades, poisoning from Pb shot (shotguns) has been recognised as a cause of disease in waterfowl and Pb shot has been subsequently banned for waterfowl hunting in many jurisdictions. However, the risks posed by Pb-based bullets (rifles) have not been similarly recognised in Australia. Pb-based rifle bullets frequently fragment, contaminating the tissue of shot animals. Consuming this Pb-contaminated tissue risks harmful Pb exposure and, thus, the health of wildlife scavengers (carrion eaters) and humans and their companion animals who consume harvested meat (game eaters). In Europe, North America and elsewhere, the environmental and human health risks of Pb-based bullets are widely recognised, and non-toxic alternatives (e.g. copper-based bullets) are increasingly being used. However, Australia has no comparable research despite widespread use of shooting, common scavenging by potentially susceptible wildlife species, and people regularly consuming shot meat. We conclude that Australia has its collective ‘head in the sand’ on this pressing worldwide One Health issue. We present the need for urgent research into this field in Australia.