Economic implications of mercury exposure in the context of the global mercury treaty: Hair mercury levels and estimated lost economic productivity in selected developing countries

Low mercury risks in paddy soils across the Pakistan

Mercury (Hg) is a globally distributed heavy metal. Here, we study Hg concentration and isotopic composition to understand the status of Hg pollution and its sources in Pakistan's paddy soil. The collected paddy soils (n = 500) across the country have an average THg concentration of 22.30 ± 21.74 ng/g. This low mean concentration suggests Hg pollution in Pakistan was not as severe as previously thought. Meanwhile, samples collected near brick kilns and industrial areas were significantly higher in THg than others, suggesting the influence of Hg emitted from point sources in certain areas. Soil physicochemical properties showed typical characteristic of mineral soils due to the study area's arid to semi-arid climate. Hg stable isotopes analysis, depicted mean Δ199Hg of -0.05 ± 0.12‰ and mean δ202Hg -0.45 ± 0.35‰, respectively, for contaminated sites, depicting Hg was primarily sourced from coal combustion by local anthropogenic sources. While uncontaminated sites show mean Δ199Hg of 0.15 ± 0.08‰, mean Δ200Hg of 0.06 ± 0.07‰ and mean δ202Hg of -0.32 ± 0.28‰, implying long-range transboundry Hg transport through wet Hg(II) deposition as a dominant Hg source. This study fills a significant knowledge gap regarding the Hg pollution status in Pakistan and suggests that the Hg risk in Pakistan paddies is generally low.

Trends of hair Hg accumulation in reproductive-age women living in Central Russia and the calculated costs of Hg-induced IQ loss in the period between 2005 and 2021

The objective of the present study was to retrospectively evaluate hair mercury (Hg) content in reproductive-age women living in Central Russia (Moscow and Moscow region), and to calculate the potential costs of the potential Hg-induced IQ loss in a hypothetical national birth cohort.

MATERIALS AND METHODS

A total of 36,263 occupationally non-exposed women aged between 20 and 40 years living in Moscow (n = 30,626) or Moscow region (n = 5637) in the period between 2005 and 2021 participated in this study. Hair Hg content was evaluated with inductively coupled plasma-mass spectrometry (ICP-MS). Hair Hg levels in reproductive-age women were used for assessment of the potential IQ loss and its costs.

RESULTS

The results demonstrate that hair Hg content in the periods between 2010 and 2015, and 2016-2021 was significantly lower than that in 2005-2009 by 26 % and 51 %, respectively. The highest hair Hg level was observed in women in 2005 (0.855 µg/g), being more than 2.5-fold higher than the lowest value observed in 2020 (0.328 µg/g). Multiple regression analysis revealed a significant inverse association between the year of analysis and hair Hg content (β = -0.288; p < 0.001). The calculations demonstrate that in 2005 the costs of IQ loss in children exceeded 1.0 (1.6) billion USD, whereas in 2020 the costs of IQ loss accounted to approximately 0.15 (0.28) billion USD.

CONCLUSION

Taken together, our data demonstrate that Hg accumulation in reproductive-age women reduced significantly in Russia from 2005 to 2021 resulting in predicted economic benefits by decreasing the costs of Hg-induced IQ loss.

Global mercury concentrations in biota: their use as a basis for a global biomonitoring framework

An important provision of the Minamata Convention on Mercury is to monitor and evaluate the effectiveness of the adopted measures and its implementation. Here, we describe for the first time currently available biotic mercury (Hg) data on a global scale to improve the understanding of global efforts to reduce the impact of Hg pollution on people and the environment. Data from the peer-reviewed literature were compiled in the Global Biotic Mercury Synthesis (GBMS) database (>550,000 data points). These data provide a foundation for establishing a biomonitoring framework needed to track Hg concentrations in biota globally. We describe Hg exposure in the taxa identified by the Minamata Convention: fish, sea turtles, birds, and marine mammals. Based on the GBMS database, Hg concentrations are presented at relevant geographic scales for continents and oceanic basins. We identify some effective regional templates for monitoring methylmercury (MeHg) availability in the environment, but overall illustrate that there is a general lack of regional biomonitoring initiatives around the world, especially in Africa, Australia, Indo-Pacific, Middle East, and South Atlantic and Pacific Oceans. Temporal trend data for Hg in biota are generally limited. Ecologically sensitive sites (where biota have above average MeHg tissue concentrations) have been identified throughout the world. Efforts to model and quantify ecosystem sensitivity locally, regionally, and globally could help establish effective and efficient biomonitoring programs. We present a framework for a global Hg biomonitoring network that includes a three-step continental and oceanic approach to integrate existing biomonitoring efforts and prioritize filling regional data gaps linked with key Hg sources. We describe a standardized approach that builds on an evidence-based evaluation to assess the Minamata Convention's progress to reduce the impact of global Hg pollution on people and the environment.

Comparative analysis between mercury levels in fish tissues evaluated using direct mercury analyzer and inductively plasma-coupled mass spectrometer

Recent ecotoxicological studies have indicated mercury (Hg) contamination in aquatic ecosystems in the Amazon Basin. Although Hg contamination can be associated with small-scale gold mining, the soils of the Amazon region have naturally high Hg concentrations, and can be transported to aquatic ecosystems via deforestation and mining activities. Biomagnification of Hg can pose risks to the local human population; therefore, its concentration in fish tissues must be monitored consistently. Fast and sensitive Hg determination is required for continuously monitoring ecosystems impacted by mineral exploration. The direct mercury analyzer (DMA-80) is widely used for determining total Hg levels in tissue samples; it is fast and cost-effective, without requiring sample preparation. Here, we determined the sensitivity and specificity of Hg detection accomplished using DMA-80, and whether these results are reliable compared to those obtained using Inductively Coupled Plasma Mass Spectrometer (ICP-MS), which is the gold standard. We obtained 106 paired dried samples of muscle tissue from fish species occupying different trophic levels in the Lower Amazon region, and analyzed them using both equipment (DMA-80 and ICP-MS). The results obtained using DMA-80 had an overall Hg mean of 1.90 ± 0.18 mg/kg which was higher (p < 0.05) than the mean of those obtained using ICP-MS (1.55 ± 0.13 mg/kg). Linear regression analysis comparing the Hg levels obtained using both devices was within the 95% prediction interval, and a high coefficient of correlation showed agreement between the devices (r = 0.979; 0.069 to 0.986, 95% CI). Bland-Altman analysis showed that DMA-80 had a positive bias of 6.5% in relation to ICP-MS, which is more evident in samples with high Hg concentrations. DMA-80 was efficient in determining whether the Hg levels exceeded the maximum allowed levels required by the European Union, USA, and Brazil, showing a specificity and sensitivity of above 95%.

Reservoir Stratification Modulates the Influence of Impoundments on Fish Mercury Concentrations along an Arid Land River System

Impoundment is among the most common hydrologic alterations with impacts on aquatic ecosystems that can include effects on mercury (Hg) cycling. However, landscape-scale differences in Hg bioaccumulation between reservoirs and other habitats are not well characterized nor are the processes driving these differences. We examined total Hg (THg) concentrations of Smallmouth Bass (Micropterus dolomieu) collected from reservoir, tailrace, and free-flowing reaches along an 863 km segment of the Snake River, USA, a semiarid river with 22 impoundments along its course. Across three size-classes (putative 1-year-old, first reproductive, and harvestable sized fish), THg concentrations in reservoirs and tailraces averaged 76% higher than those in free-flowing segments. Among reservoirs, THg concentrations were highest in reservoirs with inconsistent stratification patterns, 47% higher than annually stratified, and 144% higher than unstratified reservoirs. Fish THg concentrations in tailraces immediately downstream of stratified reservoirs were higher than those below unstratified (38-130%) or inconsistently stratified (32-79%) reservoirs. Stratification regimes influenced the exceedance of fish and human health benchmarks, with 52-80% of fish from stratifying reservoirs and downstream tailraces exceeding a human consumption benchmark, compared to 6-17% where stratification did not occur. These findings suggest that impoundment and stratification play important roles in determining the patterns of Hg exposure risk across the landscape.

Neuropsychological effects and cognitive deficits associated with exposure to mercury and arsenic in children and adolescents of the Mojana region, Colombia

The present study aims to explore the neuropsychological performance and exposure to mercury (Hg) and arsenic (As) in Colombian children and adolescents considering biomarkers in hair and blood. The total sample consisted of 70 participants from the Mojana region, Colombia. A neuropsychological evaluation protocol was used, consisting of 11 internationally recognized tests, with evidence of national validation and use for measurement in neurotoxicology contexts. A 57.1% of the sample presented levels above the reference value according to the USEPA, the WHO, and the ATSDR for total mercury in hair (HgH), blood mercury (HgB), and/or blood arsenic (AsB). The mean values reported for HgH were 1.76 ± 3.1 μg/g (95% CI 1.02-2.50) with ranges between 0.23 and 17.20; for HgB: 4.11 ± 5.93 μg/l (CI 2.69-5.52), ranging between 0.25 and 25.80, and for AsB: 1.96 ± 2.73 (CI 1.31-2.61) ranging between 0.50 and 15.50. In the comparison of groups in relation to the level of exposure, a significant difference was found (p < 0.05) for the subtest The Boston Naming Test (BNT). Correlation analyses found, on the one hand, significant negative relationships in tests integrated within the verbal (CVB) and executive function (EF) components as well as evidence of positive relationships in the manifestation of errors in their performance with the levels of Hg and/or As transformed by biomarker (Log10). In the linear regression analyses it was found that for each increase in the concentration of HgH, HgB, and AsB it is estimated that, both for the models with and without data adjustment, there is a loss of scores in integrated measures within the CVB and EF for the transformed levels of HgH, HgB, and AsB; and an increase in the reported errors in their processing within these functions. According to these results, exposure to mercury and/or arsenic is related with performance in verbal neuropsychological skills and executive functioning.

The combined effect between BDNF genetic polymorphisms and exposure to metals on the risk of Chinese dyslexia

BDNF gene has been implicated in the development of cognition and language. Meanwhile, exposure to metals might interact with BDNF gene to increase the risk of neurodevelopmental disorders. The present study aimed to explore the association between BDNF genetic polymorphisms and dyslexic risk and examine whether BDNF polymorphisms would interact with metal exposures, jointly contributing to dyslexia. Among a case-control study composed of 238 children with dyslexia and 228 healthy controls, the BDNF genetic polymorphisms were genotyped by the Sequenom MassARRAY system, and the exposure to eight metals, such as lead (Pb), mercury (Hg) and copper (Cu), were measured using an inductively coupled plasma-mass spectrometer (ICP-MS). Multivariable logistic regression models were used to assess the adjusted odds ratios (ORs) and 95% confidence interval (CI) of dyslexia. After multivariate adjustment, significant associations of dyslexic risk with rs6265 polymorphisms of the BDNF gene were observed (OR = 1.99; 95% CI: 1.15-3.44). Furthermore, exposure to Cu could interact with rs6265 to increase the risk of dyslexia (P interaction = 0.045). High-Cu children with the rs6265 TT genotype were more likely to have dyslexia compared with low-Cu children carrying CC + CT genotypes (OR = 3.19; 95% CI: 1.38-7.39). The findings of this study suggested that the polymorphism of rs6265 in BDNF gene could interact with Cu exposure to increase the occurrence of dyslexia.

Unravelling the interactive effect of soil and atmospheric mercury influencing mercury distribution and accumulation in the soil-rice system

Mercury (Hg) accumulation in rice is an emerging health concern worldwide. However, sources and interactions responsible for Hg species accumulation in different rice tissues are still uncertain. Four experimental plots were carefully designed at an artisanal Hg mining site and a control site to evaluate the effect of atmospheric and soil Hg contents on Hg accumulation in rice. We showed that inorganic Hg (IHg) contents in rice tissues grown either in contaminated or control site soil (non-contaminated soil) were higher at Hg artisanal mining site than those at the control site. Elevated total gaseous mercury (TGM) levels in ambient air were the predominant source of IHg to rice at the Hg mining area. Methylmercury (MeHg) concentrations in rice plant tissues increased in proportionality with MeHg contents in paddy soil. Our results suggest that both atmosphere and soil Hg sources have been impacted the IHg accumulation in rice. Above ground rice tissues, grains, leaves, and stalk accumulated IHg from both atmosphere and soil to varying degrees. Nonetheless, the study also provides the first direct evidence that atmospheric Hg accumulated by above-ground rice tissues could be translocated to below-ground tissues (roots). However, the extent to which atmosphere or soil Hg contributes to IHg in rice tissues may vary with each source's concentration gradient at the given site. No evidence of in planta Hg methylation was found during the current study. Hence, paddy fields are potential MeHg production sites, whereas paddy soil is a unique MeHg accumulation source in rice plants. This study expands and clarifies the contribution of various sources involved in Hg accumulation in the soil rice system. The findings here provide the basis for future research strategies to deal with the global issue of Hg contaminated rice.

Occurrence of total mercury and methylmercury in rice: Exposure and health implications in Nepal

Emerging studies have indicated that the consumption of rice could be the major methylmercury (MeHg) contributor to human mercury (Hg) exposure. Nonetheless, few studies are available on Hg in rice around the world, especially in countries with heavy rice diet. In this study, total Hg (THg) and MeHg levels in rice samples (n = 172) across Nepal were first investigated. The geometric mean THg was 7.05 ± 7.71 µg/kg with a range of 0.622 µg/kg to 158 µg/kg, and the maximum THg level was up to 791% of the Chinese National Standard Limit for THg in rice (20 µg/kg). The geometric mean MeHg was 0.820 ± 0.660 µg/kg with a range of 0.189 µg/kg to 8.59 µg/kg. Overall, the mean MeHg exposure (0.00445 ± 0.00477 µg/kg bw/day) and inorganic Hg (IHg) exposure (0.0360 ± 0.0739 µg/kg bw/day) were lower than the reference dose (RfD) of 0.1 µg/kg bw/day for MeHg and the provisional tolerable weekly intake (PTWI) of 0.571 µg/kg bw/day for IHg, respectively. Concerning different groups of vulnerable populations, the highest MeHg exposure (0.126 µg/kg bw/day) and IHg exposure (1.57 µg/kg bw/day) of preschoolers (37-50 months old) were approximately 126% of the RfD for MeHg and 275% of the PTWI for IHg. When the pregnant mothers eat the rice without awareness of the Hg content in rice, the mean and highest intelligence quotients (IQs) losses were 9554 and 118659 points, respectively, and the corresponding economic costs due to IQ loss could be 15.1 million USD and 188 million USD in Nepal. The results of rice THg and MeHg levels and corresponding exposure in populations highlighted the occurrence of rice THg and MeHg pollution issues in Nepal. More efforts should be made to protect younger groups in Nepal from high rice Hg exposure. CAPSULE: Owing to the high rice consumption rates relative to body mass, preschoolers (37-50 months) may meet the 126% reference dose (0.1 µg/kg bw/day) for MeHg and 275% provisional tolerable weekly intake (0.571 µg/kg bw/day) for IHg exposure in Nepal.

Economic Impacts on Human Health Resulting from the Use of Mercury in the Illegal Gold Mining in the Brazilian Amazon: A Methodological Assessment

Artisanal small-scale gold mining (ASGM) in the Amazon results in the dumping of tons of mercury into the environment annually. Despite consensus on the impacts of mercury on human health, there are still unknowns regarding: (i) the extent to which mercury from ASGM can be dispersed in the environment until it becomes toxic to humans; and (ii) the economic value of losses caused by contamination becomes evident. The main objective of this study is to propose a methodology to evaluate the impacts of ASGM on human health in different contexts in the Brazilian Amazon. We connect several points in the literature based on hypotheses regarding mercury dispersion in water, its transformation into methylmercury, and absorption by fish and humans. This methodology can be used as a tool to estimate the extent of environmental damage caused by artisanal gold mining, the severity of damage to the health of individuals contaminated by mercury and, consequently, can contribute to the application of fines to environmental violators. The consequences of contamination are evaluated by dose-response functions relating to mercury concentrations in hair and the development of the following health outcomes: (i) mild mental retardation, (ii) acute myocardial infarction, and (iii) hypertension. From disability-adjusted life years and statistical life value, we found that the economic losses range from 100,000 to 400,000 USD per kilogram of gold extracted. A case study of the Yanomami indigenous land shows that the impacts of mercury from illegal gold mining in 2020 totaled 69 million USD, which could be used by local authorities to compensate the Yanomami people.

Mercury Exposure among E-Waste Recycling Workers in Colombia: Perceptions of Safety, Risk, and Access to Health Information

Exposures to the toxic element mercury (Hg) are exceptionally high among recycling workers globally. Recycling is a growing sector in Colombia, yet workers who directly handle e-waste are often unaware of the risks of exposure to mercury from post-consumer lighting products (e.g., fluorescent lamps). This qualitative study aimed to understand how recycling workers perceive their own risks from mercury exposure and how they find information about these risks, through interviews (n = 35) at the three largest formal recycling facilities in Colombia. Workers' risk perception was generally disconnected from their likely actual exposure to mercury, instead often seen juxtaposed to co-workers who worked more directly with hazardous waste. Recycling workers, who were predominantly men from lower-income socioeconomic backgrounds, had limited knowledge of health risks due to mercury exposure and were more likely to receive health-related information from informal sources. Over a third of interviewees had searched online for information about occupational health risks of mercury, but these searches were perceived as unsatisfactory due to information being difficult to find, not available in Spanish, or related to mercury exposure via seafood or mining rather than recycling. Workers expressed (over)confidence in personal protective equipment and concern about frequent employee turnover. This study points to weaknesses in environmental health literacy and public health communication around toxic exposures to mercury in the workplace. Stronger regulation and enforcement are needed to prevent toxic exposures and promote worker health equity.

Relationship Between Elevated Hair Mercury Levels, Essential Element Status, and Metabolic Profile in Overweight and Obese Adults

The objective of the present study was to evaluate hair essential and trace element levels and metabolic risk markers in overweight and obese subjects in relation to body mercury burden. According to 2 × 2 factorial design a total of 440 adults were distributed to four groups: (i) low-Hg normal-weight subjects (n = 114); (ii) high-Hg normal weight subjects (n = 113); (iii) low-Hg overweight (BMI > 25) subjects (n = 110); (iv) high-Hg overweight (BMI > 25) subjects (n = 110). Hg-exposed groups consisted of subjects characterized by frequent seafood consumption (> 4 times/week) subsequently evaluated by hair analysis (> 0.58 μg/g). Dietary-exposed subjects were characterized by a more than 3-fold higher hair Hg content irrespectively of body weight values. Both low-Hg and high-Hg overweight subjects were characterized by significantly higher ALT activity, as well as elevated serum glucose, LDL, and triglyceride levels as compared to the respective groups of normal weight subjects. High Hg body burden had a more significant effect on metabolic parameters in overweight and obese adults. Particularly, high-Hg overweight subjects were characterized by significantly higher serum creatinine and uric acid levels, as well as increased GGT and CK activity as compared to low-Hg overweight counterparts. In addition, hair Mg, Mn, and Sr content in high-Hg overweight subjects was significantly lower than that in low-Hg normal weight and overweight examinees. In turn, high Hg levels in overweight subjects were associated with significantly higher hair Se and Zn levels when compared to unexposed overweight adults. Generally, the obtained data demonstrate that increased hair Hg levels in overweight and obese subjects is associated with adverse metabolic profile. It is proposed that observed metabolic alterations may be at least partially mediated by Hg-associated disturbances in essential trace element and mineral metabolism.

Neurotoxic effects of combined exposures to aluminum and mercury in early life (infancy)

Aluminum and mercury are environmentally ubiquitous. Individually they are both neurotoxic elements with shared neuro-pathogenic pathways: oxidative stress, altered neurotransmission, and disruption of the neuroendocrine and immune systems. In the infant, Al and Hg differ in type of exposure, absorption, distribution (brain access), and metabolism. In environmentally associated exposure (breast milk and infant formulas) their co-occurrences fluctuate randomly, but in Thimerosal-containing vaccines (TCVs) they occur combined in a proprietary ratio; in these cases, low-doses of Thimerosal-ethylmercury (EtHg) and adjuvant-Al present the most widespread binary mixture in less developed countries. Although experimental studies at low doses of the binary Hg and Al mixture are rare, when studied individually they have been shown to affect neurological outcomes negatively. In invitro systems, comparative neurotoxicity between Al and Hg varies in relation to the measured parameters but seems less for Al than for Hg. While neurotoxicity of environmental Hg (mainly fish methyl-Hg, MeHg) is associated with neurobehavioral outcomes in children, environmental Al is not associated, except in certain clinical conditions. Therefore, the issues of their neurotoxic effects (singly or combined) are discussed. In the infant (up to six months) the organic-Hg and Al body burdens from a full TCV schedule are estimated to reach levels higher than that originating from breastfeeding or from high aluminum soy-based formulas. Despite worldwide exposure to both Al and Hg (inorganic Hg, MeHg, and Thimerosal/EtHg), our knowledge on this combined exposure is insufficient to predict their combined neurotoxic effects (and with other co-occurring neurotoxicants).

Multiple low-level exposures: Hg interactions with co-occurring neurotoxic substances in early life

All chemical forms of Hg can affect neurodevelopment; however, low levels of organic Hg (methylmercury-MeHg and ethylmercury-EtHg in Thimerosal-containing vaccines, hereafter 'TCV') exposures during early life (pregnancy and lactation) co-occur with other environmental neurotoxic substances. These neurotoxicants may act in parallel, synergistically, or antagonistically to Hg. Nevertheless, the risks of neurotoxicity associated with multiple neuro-toxicants depend on type, time, combinations of exposure, and environmental and/or genetic-associated factors. Neurological developmental disorders, delays in cognition and behavioral outcomes associated with multiple exposures (which include Hg) may show transient or lasting outcomes depending on constitutional and/or environmental factors that can interact to neutralize, aggravate or attenuate these effects; often these studies are challenging to interpret. During pregnancy and lactation, fish-MeHg exposure is frequently confounded with the opposing effects of neuroactive nutrients (in fish) that lead to positive, negative, or no effects on neurobehavioral tests. In infancy, exposures to acute binary mixtures (TCV- EtHg and Al-adjuvants in infant immunizations) are associated with increased risks of tics and other developmental disorders. Despite the certitude that promulgates single environmental neurotoxicants, empirical comparisons of combined exposures indicate that Hg-related outcome is uneven. Hg in combination with other neurotoxic mixtures may elevate risks of neurotoxicity, but these risks arise in circumstances that are not yet predictable. Therefore, to achieve the goals of the Minamata treaty and to safeguard the health of children, low levels of mercury exposure (in any chemical form) needs to be further reduced whether the source is environmental (air- and food-borne) or iatrogenic (pediatric TCVs).

A State-of-the-Science Review of Mercury Biomarkers in Human Populations Worldwide between 2000 and 2018

BACKGROUND

The Minamata Convention on Mercury provided a mandate for action against global mercury pollution. However, our knowledge of mercury exposures is limited because there are many regions and subpopulations with little or no data.

OBJECTIVE

We aimed to increase worldwide understanding of human exposures to mercury by collecting, collating, and analyzing mercury concentrations in biomarker samples reported in the published scientific literature.

METHOD

A systematic search of the peer-reviewed scientific literature was performed using three databases. A priori search strategy, eligibility criteria, and data extraction steps were used to identify relevant studies.

RESULTS

We collected 424,858 mercury biomarker measurements from 335,991 individuals represented in 312 articles from 75 countries. General background populations with insignificant exposures have blood, hair, and urine mercury levels that generally fall under [Formula: see text], [Formula: see text], and [Formula: see text], respectively. We identified four populations of concern: a) Arctic populations who consume fish and marine mammals; b) tropical riverine communities (especially Amazonian) who consume fish and in some cases may be exposed to mining; c) coastal and/or small-island communities who substantially depend on seafood; and d) individuals who either work or reside among artisanal and small-scale gold mining sites.

CONCLUSIONS

This review suggests that all populations worldwide are exposed to some amount of mercury and that there is great variability in exposures within and across countries and regions. There remain many geographic regions and subpopulations with limited data, thus hindering evidence-based decision making. This type of information is critical in helping understand exposures, particularly in light of certain stipulations in the Minamata Convention on Mercury. https://doi.org/10.1289/EHP3904.

Neurodevelopmental Effects of Mercury

The toxicology of mercury (Hg) is of concern since this metal is ubiquitously distributed in the environment, and living organisms are routinely exposed to Hg at low to high levels. The toxic effects of Hg are well studied and it is known that they may differ depending on the Hg chemical species. In this chapter, we emphasize the neurotoxic effects of Hg during brain development. The immature brain is more susceptible to Hg exposure, since all the Hg chemical forms, not only the organic ones, can harm it. The possible consequences of Hg exposure during the early stages of development, the additive effects with other co-occurring neurotoxicants, and the known mechanisms of action and targets will be addressed in this chapter.

Prenatal mercury exposure, maternal seafood consumption and associations with child language at five years

BACKGROUND

Methyl mercury (MeHg) is a well-known neurotoxin and evidence suggests that also low level exposure may affect prenatal neurodevelopment. Uncertainty exists as to whether the maternal MeHg burden in Norway might affect child neurodevelopment.

OBJECTIVE

To evaluate the association between prenatal mercury exposure, maternal seafood consumption and child language and communication skills at age five.

METHODS

The study sample comprised 38,581 mother-child pairs in the Norwegian Mother and Child Cohort Study. Maternal mercury blood concentration in gestational week 17 was analysed in a sub-sample of 2239 women. Prenatal mercury exposure from maternal diet was calculated from a validated FFQ answered in mid-pregnancy. Mothers reported children's language and communications skills at age five by a questionnaire including questions from the Ages and Stages Questionnaire (ASQ), the Speech and Language Assessment Scale (SLAS) and the Twenty Statements about Language-Related Difficulties (language 20). We performed linear regression analyses adjusting for maternal characteristics, nutritional status and socioeconomic factors.

RESULTS

Median maternal blood mercury concentration was 1.03μg/L, dietary mercury exposure was 0.15μg/kgbw/wk, and seafood intake was 217g/wk. Blood mercury concentrations were not associated with any language and communication scales. Increased dietary mercury exposure was significantly associated with improved SLAS scores when mothers had a seafood intake below 400g/wk in the adjusted analysis. Sibling matched analysis showed a small significant adverse association between those above the 90th percentile dietary mercury exposure and the SLAS scores. Maternal seafood intake during pregnancy was positively associated with the language and communication scales.

CONCLUSION

Low levels of prenatal mercury exposure were positively associated with language and communication skills at five years. However, the matched sibling analyses suggested an adverse association between mercury and child language skills in the highest exposure group. This indicates that prenatal low level mercury exposure still needs our attention.

Calculation of the disease burden associated with environmental chemical exposures: application of toxicological information in health economic estimation

Calculation of costs and the Burden of Disease (BoD) is useful in developing resource allocation and prioritization strategies in public and environmental health. While useful, the Disability-Adjusted Life Year (DALY) metric disregards subclinical dysfunctions, adheres to stringent causal criteria, and is hampered by gaps in environmental exposure data, especially from industrializing countries. For these reasons, a recently calculated environmental BoD of 5.18% of the total DALYs is likely underestimated. We combined and extended cost calculations for exposures to environmental chemicals, including neurotoxicants, air pollution, and endocrine disrupting chemicals, where sufficient data were available to determine dose-dependent adverse effects. Environmental exposure information allowed cost estimates for the U.S. and the EU, for OECD countries, though less comprehensive for industrializing countries. As a complement to these health economic estimations, we used attributable risk valuations from expert elicitations to as a third approach to assessing the environmental BoD. For comparison of the different estimates, we used country-specific monetary values of each DALY. The main limitation of DALY calculations is that they are available for few environmental chemicals and primarily based on mortality and impact and duration of clinical morbidity, while less serious conditions are mostly disregarded. Our economic estimates based on available exposure information and dose-response data on environmental risk factors need to be seen in conjunction with other assessments of the total cost for these environmental risk factors, as our estimate overlaps only slightly with the previously estimated environmental DALY costs and crude calculations relying on attributable risks for environmental risk factors. The three approaches complement one another and suggest that environmental chemical exposures contribute costs that may exceed 10% of the global domestic product and that current DALY calculations substantially underestimate the economic costs associated with preventable environmental risk factors. By including toxicological and epidemiological information and data on exposure distributions, more representative results can be obtained from utilizing health economic analyses of the adverse effects associated with environmental chemicals.