Differences in prenatal exposure to mercury in South African communities residing along the Indian Ocean

Selenium Status, Its Interaction with Selected Essential and Toxic Elements, and a Possible Sex-Dependent Response In Utero, in a South African Birth Cohort

Selenium (Se) is an essential trace element and its deficiency in utero may affect fetus development and birth outcomes. The current study aimed to assess serum Se status at delivery and examine the possible association between Se levels and birth outcomes. The interaction of Se with selected essential and toxic elements as well as possible sex-dependent responses in utero were also evaluated. The negative association between Se levels and head circumference of neonates was evident in the total cohort (β = −0.164; p < 0.001) as well as in the pre-term and full-term cohorts. Significant positive correlations were found between maternal serum Se concentrations and zinc (Zn) and copper (Cu) in the total and regional cohorts. In the total cohort, the toxic elements lead (Pb) and arsenic (As) showed a negative correlation with Se levels, while mercury (Hg), aluminum (Al) and cadmium (Cd) showed a positive correlation. The study found a sex-dependent response in utero for Zn, Cu, Pb, Hg, and Al. The findings of the current study may inform reproductive health policy on Se status in South Africa and highlight the need for sensitive methods to measure Se intake during pregnancy and its complex interactions with other micronutrients and environmental pollutants.

In Utero Exposure to Aluminium and Other Neurotoxic Elements in Urban Coastal South African Women at Delivery: An Emerging Concern

Aluminium (Al) is a non-essential neurotoxicant and there is limited information regarding exposure to Al in utero. This study sought to evaluate the in utero exposure to Al in urban South African women, its effects on birth outcomes and possible synergistic effects between Al, essential and neurotoxic elements such as lead (Pb), mercury (Hg) and arsenic (As), as well as a a potential sex-dependent response to these elements in neonates. This study has found elevated levels of Al in urban women at delivery. The Spearman’s rank correlation coefficients (p-value) of the association between maternal serum Al and birth outcomes (gestational age and parity), and between maternal serum Al and Cu, Zn and Se, were statistically significant. However, in the general and the stratified models, no association was found between any of the birth outcomes and maternal serum Al. The association between maternal serum Al and neurotoxic elements at delivery showed a significant positive correlation for Pb only (rho = 0.361; p < 0.001) which was found to be sex-dependent in neonates (males, rho = 0.285; p < 0.004 and females, rho = 0.444, p < 0.001). Our preliminary findings indicate that in utero exposure to Al is an emerging concern requiring further research and directives from public health authorities.

Low-level methylmercury exposure through rice ingestion in a cohort of pregnant mothers in rural China

BACKGROUND

Rice ingestion is an important dietary exposure pathway for methylmercury. There are few studies concerning prenatal methylmercury exposure through rice ingestion, yet the health risks are greatest to the developing fetus, and thus should be investigated.

OBJECTIVES

Our main objective was to quantify dietary methylmercury intake through rice and fish/shellfish ingestion among pregnant mothers living in southern China, where rice was a staple food and mercury contamination was considered minimal.

METHODS

A total of 398 mothers were recruited at parturition, who donated scalp hair and blood samples. Total mercury and/or methylmercury concentrations were measured in biomarkers, in rice samples from each participant's home, and in fish tissue purchased from local markets. Additional fish/shellfish mercury concentrations were obtained from a literature search. Dietary methylmercury intake during the third trimester was equivalent to the ingestion rate for rice (or fish/shellfish)×the respective methylmercury concentration.

RESULTS

Dietary methylmercury intake from both rice and fish/shellfish ingestion averaged 1.2±1.8µg/day (median=0.79µg/day, range=0-22µg/day), including on average 71% from rice ingestion (median: 87%, range: 0-100%), and 29% from fish/shellfish consumption (median 13%, range: 0-100%). Median concentrations of hair total mercury, hair methylmercury, and blood total mercury were 0.40µg/g (range: 0.08-1.7µg/g), 0.28µg/g (range: 0.01-1.4µg/g), and 1.2µg/L (range: 0.29-8.6µg/L), respectively, and all three biomarkers were positively correlated with dietary methylmercury intake through rice ingestion (Spearman's rho=0.18-0.21, p≤0.0005), although the correlations were weak. In contrast, biomarkers were not correlated with fish/shellfish methylmercury intake (Spearman's rho=0.04-0.08, p=0.11-0.46).

CONCLUSIONS

Among pregnant mothers living in rural inland China, rice ingestion contributed to prenatal methylmercury exposure, more so than fish/shellfish ingestion.

Environmental influences on reproductive health: the importance of chemical exposures

Chemical exposures during pregnancy can have a profound and life-long impact on human health. Because of the omnipresence of chemicals in our daily life, there is continuous contact with chemicals in food, water, air, and consumer products. Consequently, human biomonitoring studies show that pregnant women around the globe are exposed to a variety of chemicals. In this review we provide a summary of current data on maternal and fetal exposure, as well as health consequences from these exposures. We review several chemical classes, including polychlorinated biphenyls, perfluoroalkyl substances, polybrominated diphenyl ethers, phenols, phthalates, pesticides, and metals. Additionally, we discuss environmental disparities and vulnerable populations, and future research directions. We conclude by providing some recommendations for prevention of chemical exposure and its adverse reproductive health consequences.

The extent of mercury (Hg) exposure among Saudi mothers and their respective infants

A total of 1016 healthy Saudi mothers and their respective infants (aged 3-12 months) were recruited from 57 Primary Health Care Centers (PHCCs) in Riyadh, Saudi Arabia, to evaluate the extent of mercury (Hg) exposure and predict its sources in the healthy Saudi population. Total Hg levels were measured in maternal urine, breast milk, blood, and hair and in the infants' urine and hair. Only 1.9% of the mothers had urinary Hg (UHg)>10 μg/l, the limit for asymptomatic adults recommended by the World Health Organization, but the median (0.99 μg/l) was higher than in other countries. Also, 49.3% of the mothers had UHg>1 μg/l, the German reference value for adults. Median infant UHg was 0.729 μg/l, and 77 and 93 % of the infants had levels higher than 0.4 and 0.1 μg/l, the reference values of the Centers for Disease Control and Prevention and for Germany, respectively. The median Hg level in breast milk was 0.884 μg/l. Even though 43.2% of the milk samples were above the background level for Hg in human milk (1 μg/l), our results were lower than those reported from other countries. Median maternal total Hg in blood was 0.637 μg/l, and only 0.4 and 6.9% of samples were higher than the Hg reference levels of 5.8 μg/l of the Environmental Protection Agency (EPA) and of 2 μg/l for Germany, respectively. Total Hg levels in hair (HHg) varied widely among mothers and infants, but only 3.9% of the mothers and 2.8% of the infants had HHg>1 μg/g (the EPA reference level). Median HHg values were 0.117 μg/g dry weight in mothers and 0.1 μg/g dry weight in infants; both were lower than in other countries. The Hg levels in mothers and their respective infants were relatively low, but our results were consistent with other studies indicating that dental amalgam fillings and fish consumption were the main predictors of maternal Hg exposure. Among the several biomarkers of Hg exposure, Hg levels in maternal hair and urine were the strongest predictors of infant exposure. The lack of an association between Hg in breast milk and Hg in infant urine and hair suggested that the infants were exposed to Hg predominately during pregnancy rather than during breastfeeding. We expect that our data can serve as a baseline for further biomonitoring and follow-up studies, particularly of the long-term impact of Hg on childhood neurodevelopment.

Elevated prenatal methylmercury exposure in Nigeria: evidence from maternal and cord blood

Methylmercury is a neurodevelopmental toxicant that is globally distributed though little is known about prenatal exposures in sub-Saharan Africa. The objective of the current study was to measure total mercury levels in cord blood and maternal blood from 95 mother-newborn pairs recruited from hospitals in Nnewi, Nigeria. The secondary aims of the study were to explore if demographic and dietary factors were associated with blood mercury levels, and to explore if mercury levels were associated with any self-reported health outcome and childbirth outcome. Maternal blood mercury levels averaged 3.6 μg L(-1) and ranged from 1.1 μg L(-1) to 9.5 μg L(-1). Cord blood mercury averaged 5.1 μg L(-1) and ranged from 1.2 μg L(-1) to 10.6 μg L(-1). The mean ratio of mercury in paired cord blood to maternal blood was 1.5 and it ranged from 0.4 to 3.2. Mercury in maternal and cord blood were significantly correlated (r=0.471). More than one-third of mothers reported eating fish at least once per day, and a weak (p=0.08) fish consumption-related increase in blood mercury was found. Cord blood mercury was positively and significantly associated with birth weight and length, and head and chest circumference. Mercury levels in 36% of the participants exceeded the biomonitoring guideline associated with the United States Environmental Protection Agency (U.S. EPA) reference dose for mercury. The study shows that pregnant women and their newborns are exposed to methylmercury and that their exposures are higher compared to general populations sampled from other regions of the world.

Global methylmercury exposure from seafood consumption and risk of developmental neurotoxicity: a systematic review

OBJECTIVE

To examine biomarkers of methylmercury (MeHg) intake in women and infants from seafood-consuming populations globally and characterize the comparative risk of fetal developmental neurotoxicity.

METHODS

A search was conducted of the published literature reporting total mercury (Hg) in hair and blood in women and infants. These biomarkers are validated proxy measures of MeHg, a neurotoxin found primarily in seafood. Average and high-end biomarkers were extracted, stratified by seafood consumption context, and pooled by category. Medians for average and high-end pooled distributions were compared with the reference level established by a joint expert committee of the Food and Agriculture Organization (FAO) and the World Health Organization (WHO).

FINDINGS

Selection criteria were met by 164 studies of women and infants from 43 countries. Pooled average biomarkers suggest an intake of MeHg several times over the FAO/WHO reference in fish-consuming riparians living near small-scale gold mining and well over the reference in consumers of marine mammals in Arctic regions. In coastal regions of south-eastern Asia, the western Pacific and the Mediterranean, average biomarkers approach the reference. Although the two former groups have a higher risk of neurotoxicity than the latter, coastal regions are home to the largest number at risk. High-end biomarkers across all categories indicate MeHg intake is in excess of the reference value.

CONCLUSION

There is a need for policies to reduce Hg exposure among women and infants and for surveillance in high-risk populations, the majority of which live in low-and middle-income countries.