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

Heavy Metal Exposure and Cardiovascular Disease

Heavy metals are harmful environmental pollutants that have attracted widespread attention due to their health hazards to human cardiovascular disease. Heavy metals, including lead, cadmium, mercury, arsenic, and chromium, are found in various sources such as air, water, soil, food, and industrial products. Recent research strongly suggests a connection between cardiovascular disease and exposure to toxic heavy metals. Epidemiological, basic, and clinical studies have revealed that heavy metals can promote the production of reactive oxygen species, which can then exacerbate reactive oxygen species generation and induce inflammation, resulting in endothelial dysfunction, lipid metabolism distribution, disruption of ion homeostasis, and epigenetic changes. Over time, heavy metal exposure eventually results in an increased risk of hypertension, arrhythmia, and atherosclerosis. Strengthening public health prevention and the application of chelation or antioxidants, such as vitamins and beta-carotene, along with minerals, such as selenium and zinc, can diminish the burden of cardiovascular disease attributable to metal exposure.

Mercury exposure in riverine populations of Terra do Meio Extractive Reserves in the Xingu basin, Amazon, Brazil

Amazon is a hotspot for mercury (Hg) contamination and Terra do Meio region, despite its protected status for sustainable use, has never been monitored for this element. Looking to address this gap, this study aimed to quantify capillary Hg concentration in riverine populations of Terra do Meio (Xingu Basin, Central Amazon, Brazil) and associated factors with high Hg levels (90 percentile). Hair samples from 182 individuals from Iriri, Riozinho do Anfrísio and Xingu Extractive Reserves (RESEX), aged between 18 and 70 years old, were collected to measure total mercury levels (HgT), and socioeconomic, demographic, and clinical-epidemiological data were annotated. Overall, high levels of Hg were observed (mean 4.985 µg/g, median 3.531 µg/g) with significant differences between localities. Among the factors related to high capillary Hg levels, male gender, smoking habit, work in agriculture, livestock or extractivism, and residence in Iriri and Riozinho do Anfrísio RESEX were highlighted. A high prevalence of symptoms related to Hg intoxication, including anxiety, memory deficit, and lower limb problems, was observed. Overall, the results reveal that communities in these RESEXs are exposed to Hg and appear to be suffering from chronic health effects. Considering the increased anthropogenic alterations observed recently in the Amazon region and the subsequent amplified environmental bioavailability of Hg, further studies and mitigating actions are critical. This includes better surveillance of illegal anthropic activities and provision of ongoing education on this matter and incentives for dietary adaptations.

Contaminant Metals and Cardiovascular Health

A growing body of research has begun to link exposure to environmental contaminants, such as heavy metals, with a variety of negative health outcomes. In this paper, we sought to review the current research describing the impact of certain common contaminant metals on cardiovascular (CV) health. We reviewed ten metals: lead, barium, nickel, chromium, cadmium, arsenic, mercury, selenium, zinc, and copper. After a literature review, we briefly summarized the routes of environmental exposure, pathophysiological mechanisms, CV health impacts, and exposure prevention and/or mitigation strategies for each metal. The resulting article discloses a broad spectrum of pathological significance, from relatively benign substances with little to no described effects on CV health, such as chromium and selenium, to substances with a wide-ranging and relatively severe spectrum of CV pathologies, such as arsenic, cadmium, and lead. It is our hope that this article will provide clinicians with a practical overview of the impact of these common environmental contaminants on CV health as well as highlight areas that require further investigation to better understand how these metals impact the incidence and progression of CV diseases.

Hair mercury is associated with dyslipidemia and cardiovascular risk: An anthropometric, biochemical and genetic cross-sectional study of Amazonian vulnerable populations

This cross-sectional study evaluated the association between human exposure to mercury and cardiovascular risk using lipid profile (including apolipoproteins) and genetic analysis of Amazonian riverine population. Anthropometric data (gender, age, height, weight, blood pressure, and neck and waist circumferences) of the participants were recorded. Total mercury and methylmercury (MeHg) content were quantified in hair by ICP-MS and GC-pyro-AFS system. Polymorphisms rs662799, rs693, rs429358 and rs7412 (of genes of apolipoproteins A-V, B, and E at positions 112 and 158, respectively) were genotyped by real-time PCR. The population presented a dyslipidemia profile significantly correlated with high mercury levels. The apolipoprotein B/apolipoprotein A-I (ApoB/ApoA-I) index was also positively correlated with mercury, supporting a possible causal relationship. Allelic distributions were similar to those described in other populations, suggesting that genetic susceptibility may not have a significant role in the lipid alterations found in this work. This study demonstrated for the first time: i) the relationship between mercury exposure and cardiovascular risk-related apolipoproteins in humans, ii) the ApoB levels and the ApoB/ApoA-I index as the risk factors more strongly associated to the mercury-related dyslipidemia in humans, and iii) the prevalence of high/moderate risk of acute myocardial infarction in the vulnerable and chronically exposed-populations of the Amazon, in addition to the genotypic profile of the three most frequent polymorphisms in apolipoproteins of relevance for cardiovascular risk. This early detection of lipid alterations is essential to prevent the development of cardiovascular diseases (CVD), especially in chronically exposed populations such as those found in the Amazon. Therefore, in addition to provide data for the Minamata Convention implementation, our work is in line with the efforts joined by all members of the World Health Organization committed to reducing premature deaths originating from non-communicable diseases by 25% in 2025, including CVD.

Evaluation of cadmium and mercury on cardiovascular and neurological systems: Effects on humans and fish

Chemicals are at the top of public health concerns and metals have received much attention in terms of toxicological studies. Cadmium (Cd) and mercury (Hg) are among the most toxic heavy metals and are widely distributed in the environment. They are considered important factors involved in several organ disturbances. Heart and brain tissues are not among the first exposure sites to Cd and Hg but they are directly affected and may manifest intoxication reactions leading to death. Many cases of human intoxication with Cd and Hg showed that these metals have potential cardiotoxic and neurotoxic effects. Human exposure to heavy metals is through fish consumption which is considered as an excellent source of human nutrients. In the current review, we will summarize the most known cases of human intoxication with Cd and Hg, highlight their toxic effects on fish, and investigate the common signal pathways of both Cd and Hg to affect heart and brain tissues. Also, we will present the most common biomarkers used in the assessment of cardiotoxicity and neurotoxicity using Zebrafish model.

Meta-analysis and health risk assessment of toxic heavy metals in muscles of commercial fishes in Caspian Sea

Heavy metals from contaminated seafood can have serious consequences for human health. Several studies on the amount of heavy metals in Caspian Sea fish have been conducted to ensure their food safety. This meta-analysis aimed to investigate the levels of five toxic heavy metals; Lead (Pb), Cadmium (Cd), Mercury (Hg), Chromium (Cr), and Arsenic (As) in muscles of commercial fishes of the Caspian Sea with assessing their health risk of developing oral cancer in terms of fish collection place and fish type. A systematic search was performed, and the random effect model was applied for meta-analysis. Finally, 14 studies with 30 different sets of results were included. Our results showed that the pooled estimates for Pb, Cd, Hg, Cr, and As were 0.65 mg/kg (0.52, 0.79), 0.08 mg/kg (0.07, 0.10), 0.11 mg/kg (0.07, 0.15), 1.77 mg/kg (1.26, 2.27), and 0.10 mg/kg (- 0.06, 0.26) respectively. The levels of Pb and Cd were higher than their (FAO/WHO) maximum limits. The Estimated Daily Intake (EDI) of Pb and Cd in Mazandaran, and Hg in Gilan were more than Total Daily Intake (TDI) limits. The consumers' non-carcinogenic risk (THQ) for Hg in Mazandaran and Gilan, and As in Gilan, was unsafe. Carcinogenic risk (CR) for Cr and Cd in all three provinces, and for As in Mazandaran and Gilan, was greater than 1*10 - 4 and was unsafe. The lowest and highest risk levels of oral cancer were for Rutilus kutum and Cyprinus carpio respectively.

Maternal Mercury Exposure and Hypertensive Disorders of Pregnancy: A Systematic Review

OBJECTIVE

 The present review aimed to synthesize the evidence regarding mercury (Hg) exposure and hypertensive disorders of pregnancy (HDP).

DATA SOURCES

 The PubMed, BVS/LILACS, SciELO and UFRJ's Pantheon Digital Library databases were systematically searched through June 2021.

STUDY SELECTION

 Observational analytical articles, written in English, Spanish, or Portuguese, without time restriction.

DATA COLLECTION

 We followed the PICOS strategy, and the methodological quality was assessed using the Downs and Black checklist.

DATA SYNTHESIS

 We retrieved 77 articles, of which 6 met the review criteria. They comprised 4,848 participants, of which 809 (16.7%) had HDP and 4,724 (97.4%) were environmentally exposed to Hg (fish consumption and dental amalgam). Mercury biomarkers evaluated were blood (four studies) and urine (two studies). Two studies found a positive association between Hg and HDP in the group with more exposure, and the other four did not present it. The quality assessment revealed three satisfactory and three good-rated studies (mean: 19.3 ± 1.6 out 28 points). The absence or no proper adjustment for negative confounding factor, such as fish consumption, was observed in five studies.

CONCLUSION

 We retrieved only six studies, although Hg is a widespread toxic metal and pregnancy is a period of heightened susceptibility to environmental threats and cardiovascular risk. Overall, our review showed mixed results, with two studies reporting a positive association in the group with more exposure. However, due to the importance of the subject, additional studies are needed to elucidate the effects of Hg on HDP, with particular attention to adjusting negative confounding.

Health Risk Assessment Attributed to Consumption of Fish Contaminated with Mercury in the Rio Branco Basin, Roraima, Amazon, Brazil

The aim of this study was to assess the health risk attributable to the consumption of mercury-contaminated fish for the urban and non-urban populations living in the Roraima state, Amazon, Brazil. Seventy-five fish specimens distributed across twenty different species, comprising four trophic levels (i.e., herbivore, omnivore, detritivore, and carnivore), were collected at four locations in the Branco River Basin. The fish samples were sent to the Toxicology Laboratory at Evandro Chagas Institute to determine the total-Hg levels by using the cold vapor atomic system (CVAAS). The total-Hg levels ranged from 0 to 3.159 µg/g. The average concentration in non-carnivorous species (n = 32) was 0.116 µg/g, and among carnivorous fish (n = 43), it was 0.869 µg/g. The weighted average of contamination levels for all samples was 0.545 µg/g. The health risk assessment was conducted according to the methodology proposed by the World Health Organization and different scenarios of human exposure were considered, based on three levels of fish consumption (low: 50 g/day; moderate: 100 g/day and high: 200 g/day). Women of childbearing age ingest 5 to 21 times more mercury than the dose considered safe by the U.S. EPA and intake a dose from 2 to 9 times higher than the safe dose proposed by FAO/WHO. Children under 5 years of age ingest from 18 to 75 times the dose proposed by the U.S. EPA and from 8 to 32 more mercury than the limit proposed by FAO/WHO. In summary, regardless of the level of fish consumption, type of residency (urban or non-urban), and the subset of the population analyzed, anyone who consumes fish from the locations sampled is at high risk attributable to mercury ingestion, with the only exception of adult men, who consume an average of 50 g of fish per day.

Hair methylmercury levels are inversely correlated with arterial stiffness

BACKGROUND AND AIMS

Cardiovascular diseases (CVD), including coronary heart disease, are the leading cause of death worldwide. Several studies investigating the relationship between fish intake, methylmercury exposure, and CVDs in adults have reported inconsistent results. This study aimed to determine the association between hair methylmercury levels and arterial stiffness using brachial-ankle pulse wave velocity (baPWV).

METHODS

This cross-sectional study included 891 seemingly healthy Korean adults (418 men and 473 women). The anthropometric and biochemical profiles, including methylmercury levels in the hair, were measured. Arterial stiffness was measured using baPWV, wherein high baPWV was defined as >1375 cm/s (>75th percentile). The odds ratios for high baPWVs were examined using multivariable logistic regression analysis after adjusting for potential confounders across the quintiles of hair methylmercury levels (Q1 = ≤0.6, Q2 = 0.6-0.8, Q3 = 0.8-1.1, Q4 = 1.1-1.5, and Q5=>1.5 μg/g).

RESULTS

After adjusting for multiple confounders-age, sex, height, body weight, smoking status, weekly alcohol consumption, total metabolic equivalent of task, mean arterial blood pressure, resting heart rate, triglycerides, low density lipoprotein cholesterol, fasting plasma glucose, uric acid and white blood cell count-the odds ratios (95% confidence intervals) for high baPWVs in each quintile of hair methylmercury levels were 1.00, 0.36 (0.17-0.76), 0.38 (0.20-0.76), 0.28 (0.13-0.61), and 0.49 (0.24-0.99), respectively.

CONCLUSIONS

Within non-toxic low levels, higher hair methylmercury levels are independently associated with lower arterial stiffness in seemingly healthy Korean adults regardless of classical cardiovascular risk factors.

Fish consumption habits of pregnant women in Itaituba, Tapajós River basin, Brazil: risks of mercury contamination as assessed by measuring total mercury in highly consumed piscivore fish species and in hair of pregnant women

The Tapajós River basin in the Amazon region, Brazil is one of the most active gold mining areas in the world. In this study, we evaluated fish consumption habits and mercury exposure in 110 pregnant women in the city of Itaituba by measuring their total hair mercury concentrations. In addition, we investigated seasonal differences in mercury concentrations in two highly consumed piscivorous fish species, tucunaré (Cichla spp.) and pescada (Plagioscion squamosissimus). Total fish mercury concentrations (THg) during the dry season were 0.62±0.07 mg/kg for Cichla spp. and 0.73±0.08 mg/kg for P. squamosissimus. During the rainy season they were 0.39±0.04 and 0.84±0.08 mg/ kg, respectively. Of our participants 44 % declared that they ate Cichla spp. and 67 % P. squamosissimus. Mean mercury concentration in their hair was 1.6±0.2 mg/kg and was above the US Environmental Protection Agency (US EPA) reference dose of 1 mg/kg in 48 % of them. Mean fish THg concentrations were also above the joint Food and Drug Administration and US EPA safety limit of 0.5 mg/kg for P. squamosissimus during both seasons and for Cichla spp. during the dry season only. These results show that pregnant women should avoid consumption of these piscivorous fish species during pregnancy and call for a regular programme to monitor Hg levels in that area.

Interplay of Obesity, Ethanol, and Contaminant Mixture on Clinical Profiles of Cardiovascular and Metabolic Diseases: Evidence from an Animal Study

Obesity, ethanol, and contaminants are known risk factors of cardiovascular and metabolic diseases (CMD). However, their interplay on clinical profiles of these diseases remains unclear, and thus were investigated in this study. Male lean or obese JCR rats were given water or 10% ethanol and orally treated with or without a contaminant mixture (CM) dissolved in corn oil and loaded on two cookies at 0, 1.6, or 16 mg/kg BW/day dose levels for 4 weeks. The CM consisted 22 environmental contaminants found in human blood or serum of Northern populations. Over 60 parameters related to CMD were examined. The results revealed that obesity in JCR rats resembles the clinical profiles of non-alcoholic fatty liver disease in humans. Obesity was also associated with increased serum and organ retention of mercury, one of the chemical components of CM. Exposure to ethanol lightened hyperlipidemia, increased liver retention of mercury, and increased risk for hypertension in the obese rats. CM lessened hyperlipidemia and hyperenzymemia, worsened systemic inflammation and increased the risk for hypertension in the obese rats. CM markedly increased serum ethanol levels with or without ethanol exposure. Tissue total mercury contents significantly correlated with clinical parameters with altered profiles by both ethanol and obesity. These results suggest that obese individuals may be more prone to contaminant accumulation. Ethanol and CM exposure can alter clinical profiles associated with obesity, which may lead to misdiagnosis of CMD associated with obesity. CM can alter endogenous production and/or metabolism of ethanol, further complicating disease progression, diagnosis, and treatment.

Chemical toxicity assessment and Physiological investigation in rats exposed to pyrethroid insecticide type 1 and possible mitigation of propolis

The current investigation aims to study the potential protective effects of propolis methanolic extract (100 mg/kg BW) on the systemic toxic effects after dietary exposure concentration (1/100 LD50 for 30 days) of permethrin (PM) administered in experimental rats. In this experiment, we added propolis four weeks after PM -administration to examining the medicinal effects. Therapeutic use of propolis mitigated PM -induced deterioration of liver and kidney functions and myocardial damage measured by cardiac enzymes lactate dehydrogenase (LDH) and creatine kinase MB (CK-MB) in serum. In addition, propolis treatment (prophylactic and therapeutic) prevented PM-induced apoptosis index, including B-cell lymphoma protein 2 (BCL-2)-associated X (BAX) protein activates, and lipid peroxide (LP). The results showed propolis induced a significant decrease in serum levels of thyroid hormones (T3 and T4), proinflammatory cytokines tumor necrosis factor-alpha (TNF-α), interferon-gamma (INF-γ), interleukin one beta (IL-1β), interleukin 12 (IL-12), and interleukin 6 (IL-6). Besides, nuclear factor-kappa B (NF-kB), acetylcholine esterase (AChE), and hematological constituents. Cardiac biomarkers, liver, and kidney functions were substantially lower in propolis treatment. High-performance liquid chromatography (HPLC) and Gas chromatography–mass spectrometry (GC- MS) of the propolis-MeOH extract showed valuable antioxidant phenolics and flavonoids capable of alleviating oxidative stress through the free-radical scavenging efficacy and regulating signaling pathways of proinflammatory cytokines.

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 in Munduruku Indigenous Communities from Brazilian Amazon: Methodological Background and an Overview of the Principal Results

The Amazonian indigenous peoples depend on natural resources to live, but human activities' growing impacts threaten their health and livelihoods. Our objectives were to present the principal results of an integrated and multidisciplinary analysis of the health parameters and assess the mercury (Hg) exposure levels in indigenous populations in the Brazilian Amazon. We carried out a cross-sectional study based on a census of three Munduruku indigenous villages (Sawré Muybu, Poxo Muybu, and Sawré Aboy), located in the Sawré Muybu Indigenous Land, between 29 October and 9 November 2019. The investigation included: (i) sociodemographic characterization of the participants; (ii) health assessment; (iii) genetic polymorphism analysis; (iv) hair mercury determination; and (v) fish mercury determination. We used the logistic regression model with conditional Prevalence Ratio (PR), with the respective 95% confidence intervals (CI95%) to explore factors associated with mercury exposure levels ≥6.0 µg/g. A total of 200 participants were interviewed. Mercury levels (197 hair samples) ranged from 1.4 to 23.9 μg/g, with significant differences between the villages (Kruskal-Wallis test: 19.9; p-value < 0.001). On average, the general prevalence of Hg exposure ≥ 6.0 µg/g was 57.9%. For participants ≥12 years old, the Hg exposure ≥6.0 µg/g showed associated with no regular income (PR: 1.3; CI95%: 1.0-1.8), high blood pressure (PR: 1.6; CI95%: 1.3-2.1) and was more prominent in Sawré Aboy village (PR: 1.8; CI95%: 1.3-2.3). For women of childbearing age, the Hg exposure ≥6.0 µg/g was associated with high blood pressure (PR: 1.9; CI95%: 1.2-2.3), with pregnancy (PR: 1.5; CI95%: 1.0-2.1) and was more prominent among residents in Poxo Muybu (PR: 1.9; CI95%: 1.0-3.4) and Sawré Aboy (PR: 2.5; CI95%: 1.4-4.4) villages. Our findings suggest that chronic mercury exposure causes harmful effects to the studied indigenous communities, especially considering vulnerable groups of the population, such as women of childbearing age. Lastly, we propose to stop the illegal mining in these areas and develop a risk management plan that aims to ensure the health, livelihoods, and human rights of the indigenous people from Amazon Basin.

Living in the Southern Hemisphere: Metabolic Syndrome and Its Components in Amazonian Riverine Populations

The metabolic syndrome (MetS) epidemic is a global challenge. Although developing countries (including Brazil, India, and South Africa) present a higher proportion of deaths by cardiovascular diseases than developed countries, most of our knowledge is from these developed countries. Amazonian riverine populations (ARP), as well as other vulnerable populations of the Southern Hemisphere, share low-income and traditional practices, among other features. This large cross-sectional study of ARP (n = 818) shows high prevalence of hypertension (51%) and obesity (23%). MetS was diagnosed in 38% of participants (especially in women and 60-69 years-old individuals) without the influence of ancestry. Only 7-8% of adults had no cardio-metabolic abnormalities related to MetS. Atherogenic dyslipidemia (low HDL-cholesterol) was generally observed, including in individuals without MetS. Still, slight differences were detected between settings with a clear predominance of hypertension in Tucuruí. Hypotheses on possible genetic influence and factors (nutrition transition and environmental pollutants -mercury) are proposed for future studies. Moreover, a roadmap to MetS progression based on the most prevalent components is provided for the development of tailored interventions in the Amazon (initially, individuals would present low HDL-cholesterol levels, later progressing to increased blood pressure characterizing hypertension, and ultimately reaching MetS with obesity). Our alarming results support the need to improve our knowledge on these vulnerable populations.

Health Risk Assessment of Mercury Exposure from Fish Consumption in Munduruku Indigenous Communities in the Brazilian Amazon

Fish serves as the principal source of animal protein for the indigenous people of the Amazon, ensuring their food and nutritional security. However, gold mining causes mercury (Hg) contamination in fish, and consequently increases health risks associated with fish consumption. The aim of this study was to assess the health risk attributed to the consumption of mercury-contaminated fish by Munduruku indigenous communities in the Middle-Tapajós Region. Different fish species were collected in the Sawré Muybu Indigenous Land to determine mercury levels. The health risk assessment was carried out according to the World Health Organization (WHO 2008) methodology and different scenarios were built for counterfactual analysis. Eighty-eight fish specimens from 17 species and four trophic levels were analyzed. Estimates of Hg ingestion indicated that the methylmercury daily intake exceeds the U.S. EPA (United States Environmental Protection Agency) (2000) reference dose from 3 to 25-fold, and up to 11 times the FAO (Food and Agriculture Organization)/WHO (2003) dose recommendation. In all situations analyzed, the risk ratio estimates were above 1.0, meaning that the investigated Munduruku communities are at serious risk of harm as a result of ingestion of mercury-contaminated fish. These results indicate that, at present, fish consumption is not safe for this Munduruku population. This hazardous situation threatens the survival of this indigenous population, their food security, and their culture.

Erythrocytes as a Model for Heavy Metal-Related Vascular Dysfunction: The Protective Effect of Dietary Components

Heavy metals are toxic environmental pollutants associated with severe ecological and human health risks. Among them is mercury (Hg), widespread in air, soil, and water, due to its peculiar geo-biochemical cycle. The clinical consequences of Hg exposure include neurotoxicity and nephrotoxicity. Furthermore, increased risk for cardiovascular diseases is also reported due to a direct effect on cardiovascular tissues, including endothelial cells, recently identified as important targets for the harmful action of heavy metals. In this review, we will discuss the rationale for the potential use of erythrocytes as a surrogate model to study Hg-related toxicity on the cardiovascular system. The toxic effects of Hg on erythrocytes have been amply investigated in the last few years. Among the observed alterations, phosphatidylserine exposure has been proposed as an underlying mechanism responsible for Hg-induced increased proatherogenic and prothrombotic activity of these cells. Furthermore, following Hg-exposure, a decrease in NOS activity has also been reported, with consequent lowering of NO bioavailability, thus impairing endothelial function. An additional mechanism that may induce a decrease in NO availability is the generation of an oxidative microenvironment. Finally, considering that chronic Hg exposure mainly occurs through contaminated foods, the protective effect of dietary components is also discussed.

Eating in the Amazon: Nutritional Status of the Riverine Populations and Possible Nudge Interventions

The Amazon is the largest tropical forest in the world and a source of healthy food, such as fruits and fish. Surprisingly, the Amazonian riverine population present an increased prevalence (as high as 58%) of non-communicable diseases, such as hypertension and insulin resistance, even higher than that described for the urban population of the Amazon. Therefore, this work aimed to analyze the nutritional status and associated risk of the riverine population. Body mass index, waist circumference (WC), waist-to-hip ratio, and neck circumference (NC) were evaluated, and risk analysis was assayed. Furthermore, data about occupation and the prevalence of consumers of the different groups of food were analyzed. All anthropometric parameters revealed high proportions of individuals at risk, WC and NC being the factors that had more high-risk women and men, respectively. Our data confirmed the characteristic profile of the riverine communities with a high number of fish consumers, but also observed different patterns probably associated to a phenomenon of nutrition transition. Based on our data, some nudge interventions that take into account the principles of behavior analysis are discussed and proposed for these populations, aiming to improve the nutritional status and avoid the long-term consequences of the results showed by this work.

Endothelial Dysfunction Induced by Cadmium and Mercury and its Relationship to Hypertension

Hypertension is an important public health concern that affects millions globally, leading to a large number of morbidities and fatalities. The etiology of hypertension is complex and multifactorial, and it involves environmental factors, including heavy metals. Cadmium and mercury are toxic elements commonly found in the environment, contributing to hypertension. We aimed to assess the role of cadmium and mercury-induced endothelial dysfunction in the development of hypertension. A narrative review was carried out through database searches. In this review, we discussed the critical roles of cadmium and mercury in the etiology of hypertension and provided new insights into potential mechanisms of their effect, focusing primarily on endothelial dysfunction. Although the mechanisms by which cadmium and mercury induce hypertension have yet to be completely elucidated, evidence for both implicates impaired nitric oxide signaling in their hypertensive etiology.

The Relationship between Cytokine Profile and Hypertension among the Mercury-Exposed Residents of Temirtau Region in Central Kazakhstan

Background:

Mercury is a common environmental contaminant and it is also harmful to human health. Among reported toxicities, its harmful effect on hypertension is poorly documented. In Kazakhstan, Temirtau city has been reported to have a high level of mercury contamination from an acetaldehyde production factory. Therefore, we aimed to investigate the association between serum profile of cytokines and the development of hypertension among the exposed citizens.

Methods:

We selected 81 individuals for study, out of them, 41 exposed ones suffered hypertension and 40 – unexposed healthy controls in villages Chkalovo, Samarkand, Gagarinskoye, Tegiszhol, Rostovka in 2016. Mercury content in urine was studied by inversion voltammetry. Cytokine levels of IL-2, IL-6, IL-10 and TNF-α were determined by ELISA.

Results:

Mercury-exposed citizens, especially those with hypertension, had significantly higher concentrations of inflammatory cytokines TNF-α, IL-2, IL-6 and anti-inflammatory cytokine IL-10 as compared to the unexposed population. The dependence of the mercury level in urine on IL-2 content was also detected. Therefore, chronic low doses of exposure to mercury were associated with an increase in serum levels of immune markers and with the increased risk of hypertension.

Conclusion:

The presence of mercury in the body probably affected the expression of interleukin-2, one of the main cytokines that coordinate immune response.

A Systematic Review of Environmental Health Outcomes in Selected American Indian and Alaska Native Populations

BACKGROUND

Economic and social marginalization among American Indians and Alaska Natives (AI/ANs) results in higher chronic disease prevalence. Potential causal associations between toxic environmental exposures and adverse health outcomes within AI/AN communities are not well understood.

OBJECTIVES

This review examines epidemiological literature on exposure to toxicants and associated adverse health outcomes among AI/AN populations.

METHODS

PubMed, Embase, Cochrane, Environment Complete, Web of Science Plus, DART, and ToxLine were searched for English-language articles. The following data were extracted: lead author's last name, publication year, cohort name, study location, AI/AN tribe, study initiation and conclusion, sample size, primary characteristic, environmental exposure, health outcomes, risk estimates, and covariates.

RESULTS

About 31 articles on three types of environmental exposures met inclusion criteria: persistent organic pollutants (POPs), heavy metals, and open dumpsites. Of these, 17 addressed exposure to POPs, 10 heavy metal exposure, 2 exposure to both POPs and heavy metals, and 2 exposure to open dumpsites. Studies on the Mohawk Nation at Akwesasne; Yupik on St. Lawrence Island, Alaska; Navajo Nation; Gila River Indian Community; Cheyenne River Sioux; 197 Alaska Native villages; and 13 tribes in Arizona, Oklahoma, North Dakota, and South Dakota that participated in the Strong Heart Study support associations between toxicant exposure and various chronic conditions including cardiovascular conditions, reproductive abnormalities, cancer, autoimmune disorders, neurological deficits, and diabetes.

DISCUSSION

The complex interplay of environmental and social factors in disease etiology among AI/ANs is a product of externally imposed environmental exposures, systemic discrimination, and modifiable risk behaviors. The connection between environmental health disparities and adverse health outcomes indicates a need for further study.

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.

Toxicity of mercury: Molecular evidence

Minamata disease in Japan and the large-scale poisoning by methylmercury (MeHg) in Iraq caused wide public concerns about the risk emanating from mercury for human health. Nowadays, it is widely known that all forms of mercury induce toxic effects in mammals, and increasing evidence supports the concern that environmentally relevant levels of MeHg could impact normal biological functions in wildlife. The information of mechanism involved in mercurial toxicity is growing but knowledge gaps still exist between the adverse effects and mechanisms of action, especially at the molecular level. A body of data obtained from experimental studies on mechanisms of mercurial toxicity in vivo and in vitro points to that disruption of the antioxidant system may play an important role in the mercurial toxic effects. Moreover, the accumulating evidence indicates that signaling transduction, protein or/and enzyme activity, and gene regulation are involving in mediating toxic and adaptive response to mercury exposure. We conducted here a comprehensive review of mercurial toxic effects on wildlife and human, in particular synthesized key findings of molecular pathways involved in mercurial toxicity from the cells to human. We discuss the molecular evidence related mercurial toxicity to the adverse effects, with particular emphasis on the gene regulation. The further studies relying on Omic analysis connected to adverse effects and modes of action of mercury will aid in the evaluation and validation of causative relationship between health outcomes and gene expression.

Spatiality in Health: The Distribution of Health Conditions Associated with Electronic Waste Processing Activities at Agbogbloshie, Accra

Background

A walk through the Agbogbloshie e-waste recycling site shows a marked heterogeneity in the spatial distribution of the different e-waste processing activities, which are likely to drive clustering of health conditions associated with the different activity type in each space.

Objective of study

To conduct a spatial assessment and analysis of health conditions associated with different e-waste activities at different activity spaces at Agbogbloshie.

Methods

A choropleth showing the various activity spaces at the Agbogbloshie e-waste site was produced by mapping boundaries of these spaces using Etrex GPS device and individuals working in each activity spaces were recruited and studied. Upon obtaining consent and agreeing to participate in the study, each subject was physically examined and assessed various health outcomes of interest via direct physical examination while characterizing and enumerating the scars, lacerations, abrasions, skin condition and cuts after which both systolic and diastolic blood pressure values were recorded alongside the administration of open and close ended questionnaires. All individuals working within each activity space and consented to participate were recruited; giving a total of one hundred and twelve (112) subjects in all.

Results

A study of the choropleth showed that health conditions associated e-waste processing activities were clustered in a fashion similar to the corresponding distribution of each activity. While a total of 96.2% of all the study subjects had cuts, the dismantlers had higher mix of scars, lacerations and abrasions. Abrasions were observed in 16.3% of the dismantlers. Scars were the most common skin condition and were observed on the skins of 93.6% of the subjects. Prevalence of burns among the study subjects was 23.1%. Developing hypertension was not associated with activity type and while a total of 90.2% of subjects had normal blood pressure and 9.8% of them were hypertensives. Finally, 98.2% of respondents felt the need to have a first aid clinic at the site with 96.4% and 97.3% willing to visit the clinic and pay for services respectively.

Conclusion

We conclude that while the observed injuries were random and were due purely to accidents without any role of spatial determinants such as the configuration, slope, topography and other subterranean features of the activity spaces, a strong association between the injuries and activity type was observed.

Factors Associated with High Mercury Levels in Women and Girls from The Mojana Region, Colombia, 2013-2015

Women are primarily exposed to mercury through the consumption of fish contaminated by gold mining activities. The main systems affected are the central nervous and renal systems, although effects on the reproductive system have also been found. Objective: To explore the relationship between mercury levels in women and their possible sources of contamination. A cross-sectional study was conducted from 2013 to 2015 with women residing in 11 municipalities in La Mojana, Colombia, using non-random sampling. Standardized instruments were used to identify sociodemographic characteristics, mercury use, mining-related activities, water and fish consumption, and other factors. Blood, urine, and hair samples were taken to quantify mercury levels. A logistic regression model was used to identify factors associated with elevated mercury values in the participants’ samples. A total of 428 women were included, with an average age of 36.7 ± 16.7 years, 3.3% of whom were pregnant at the time of the survey and 8.4% of whom were exposed occupationally. High levels of mercury were present in 62.8% of the women, in any one of the three samples processed. Those exposed occupationally and environmentally had similar values (p = 0.821). Frequency of fish consumption and source of drinking water were associated with higher levels of mercury (p < 0.05).

Exposure to Dental Filling Materials and the Risk of Dementia: A Population-Based Nested Case Control Study in Taiwan

When studying the range of toxic substances triggering dementia, special attention should be paid to the materials used in dental practice, particularly to dental fillings containing amalgam. This necessitated conducting large-scale epidemiologic studies. The aim of our research was to determine the risk factors for developing dementia when filling materials containing amalgam are used in dental practice. In order to achieve the set goals, the following tasks were undertaken: (1) The social and demographic characteristics of the examined patients were studied; (2) the spectrum of concomitant somatic diseases was determined in patients of different gender and age; and (3) the relationship between dementia incidence and the volume of dental filling material containing amalgam was identified in patients with different somatic diseases. In general, the research conducted did not reveal any direct relationship between the development of dementia and the volume of filling material containing amalgam. However, among the people with dementia, there were persons for whom its progression was accelerated in cases where a large volume of dental filling material containing amalgam was present.

A study of relationship between blood mercury concentration and hypertension in residents living in old mine fields and related factors

Background

In Korea, around the abandoned metal mines, heavy metals are being accumulating in the cultivated areas. Among exposed heavy metals, mercury is known to harm for cardiovascular system known to affect blood pressure. So, we studied the relationship between blood mercury level and hypertension in residents around abandoned metal mines.

Methods

From 2008 to 2011, we surveyed 7,055 residents in provinces affected by abandoned metal mines and collected data from 6 Hospitals. We conducted a personal questionnaire interview survey with residents on the basis of household questionnaires, sex, age, household income, smoking, and drinking items. Multiple logistic regression analysis was performed to investigate the association between blood mercury level and hypertension.

Results

We compared residents with low and high groups based on blood mercury level 5.8 μg/L, and higher group was significantly higher risk of hypertension than lower group (odds ratio [OR]: 1.277; 95% confidence interval [CI]: 1.135–1.436), also in adjusted model, higher group was significantly higher risk of hypertension than lower group (OR: 1.276; 95% CI: 1.117–1.457).

Conclusions

This study showed a significant correlation between mercury and hypertension in residents around abandoned metal mines. Therefore, we should continuously monitor people who are higher than the standard value and the hypertensive patients.

Mercury exposure of children living in Amazonian villages: influence of geographical location where they lived during prenatal and postnatal development

INTRODUCTION

In some Amazonian river basins, hair mercury concentration is above the recommended levels. We evaluated the influence of birth geographical location in the hair mercury level of Amazonian riverine children.

MATERIALS AND METHODS

Hair mercury concentration was measured in 219 children living in four Amazonian riverine communities: Tapajós River (São Luiz do Tapajós and Barreiras villages, n = 110), Tocantins River (Limoeiro do Ajurú village, n = 61), and Caeté River (Caratateua village, n = 48). We used Poisson regression analysis to evaluate the association between native and non-native children from each village and its hair mercury concentration.

RESULTS

Higher mercury exposure was found in native children from São Luiz do Tapajós (range = 0.81-22.38 µg/g) followed by native children from Barreiras (range = 0.48-13.46 µg/g), non-native children from São Luiz do Tapajós (range = 0.26-22.18 µg/g), non-native children from Barreiras (range = 0.43-20.76 µg/g), followed by the children from Caeté and Tocantins river basins. We observed that Tapajós villages' native children had higher prevalence of mercury exposure children than other children (p < 0.05).

CONCLUSIONS

Birth geographical location has association to mercury levels in the hair of children who lived in a same community with history of mercury exposure.

Effects of methylmercury and retinol palmitate co-administration in rats during pregnancy and breastfeeding: Metabolic and redox parameters in dams and their offspring

Ubiquitous low-dose methylmercury (MeHg) exposure through an increased fish consumption represents a global public health problem, especially among pregnant women. A plethora of micronutrients presented in fish affects MeHg uptake/distribution, but limited data is available. Vitamin A (VitA), another fish micronutrient is used in nutritional supplementation, especially during pregnancy. However, there is no information about the health effects arising from their combined exposure. Therefore, the present study aimed to examine the effects of both MeHg and retinyl palmitate administered on pregnant and lactating rats in metabolic and redox parameters from dams and their offspring. Thirty Wistar female rats were orally supplemented with MeHg (0,5 mg/kg/day) and retinyl palmitate (7500 µg RAE/kg/day) via gavage, either individually or in combination from the gestational day 0 to weaning. For dams (150 days old) and their offspring (31 days old), glycogen accumulation (hepatic and cardiac) and retinoid contents (plasma and liver) were analyzed. Hg deposition in liver tissue was quantified. Redox parameters (liver, kidney, and heart) were evaluated for both animals. Cytogenetic damage was analyzed with micronucleus test. Our results showed no general toxic or metabolic alterations in dams and their offspring by MeHg-VitA co-administration during pregnancy and lactation. However, increased lipoperoxidation in maternal liver and a disrupted pro-oxidant response in the heart of male pups was encountered, with apparently no particular effects in the antioxidant response in female offspring. GST activity in dam kidney was altered leading to possible redox disruption of this tissue with no alterations in offspring. Finally, the genomic damage was exacerbated in both male and female pups. In conclusion, low-dose MeHg exposure and retinyl palmitate supplementation during gestation and lactation produced a potentiated pro-oxidant effect, which was tissue-specific. Although this is a pre-clinical approach, we recommend precaution for pregnant women regarding food consumption, and we encourage more epidemiological studies to assess possible modulations effects of MeHg-VitA co-administration at safe or inadvertently used doses in humans, which may be related to specific pathologies in mothers and their children.

Fish Intake, Circulating Mercury and Mortality in Renal Transplant Recipients

Marine-derived omega-3 polyunsaturated fatty acids (n-3 PUFAs) are inversely associated with cardiovascular and all-cause mortality in renal transplant recipients (RTRs). Recommendations to increase marine-derived n-3 PUFAs by increasing fish intake may have a drawback in concomitant stimulation of mercury intake, which could lead to higher circulating mercury concentrations and mitigation of otherwise beneficial effects of n-3 PUFAs. We aimed to monitor circulating mercury concentrations, and to prospectively evaluate whether it counteracts the potential association between fish intake and cardiovascular and all-cause mortality in a cohort of RTRs (n = 604, 53 ± 13 years-old, 57% men) with long-term follow-up (median of 5.4 years; 121 deaths). Circulating mercury concentration (median 0.30 (IQR 0.14–0.63) µg/L) positively associated with fish intake (std. β = 0.21, p < 0.001). Multivariable-adjusted Cox-proportional hazards regression analyses showed that prior to, and after additional adjustment for circulating mercury concentrations, fish intake was inversely associated with both cardiovascular (HR 0.75, 95% CI 0.58–0.96; and, HR 0.75, 95% CI 0.58–0.97, respectively) and all-cause mortality (HR 0.84, 95% CI 0.72–0.97; and, HR 0.86, 95% CI 0.74–0.99, respectively). Secondary analyses accounting for marine-derived n-3 PUFAs intake revealed associations of similar magnitude. In conclusion, we found no evidence of a counteracting effect conferred by circulating mercury concentrations on the associations between fish and marine-derived n-3 PUFAs intake and the risks of cardiovascular and all-cause mortality in RTRs.

In the Heart of the Amazon: Noncommunicable Diseases and Apolipoprotein E4 Genotype in the Riverine Population

The Amazon River basin is the largest tropical forest in the world. Most of the Amazon belongs to Brazil, a developing country that currently faces huge challenges related to the consolidation of its universal healthcare system. Noncommunicable diseases (NCDs) are the leading cause of death in Brazil, accounting for 74% of all deaths, and NCDs are probably underestimated in Amazonian population because of their geographical isolation and the precariousness of riverine communities. Important risk factors, such as genetic susceptibility, remain undetermined in the riverine population. This study performed fasting blood sugar (FBS) and blood pressure measurements and investigated the presence of the ε4 allele of apolipoprotein E (APOE4) to determine the prevalence of diabetes, hypertension and the genetic risk of NCDs. FBS and APOE4 were measured in blood samples from 763 participants using spectrometry and real-time PCR; 67.5% showed altered measurements, and 57.9% had never been diagnosed or treated. Altered FBS was found in 28.3% of the participants, hypertension in 57.6% and APOE4 in 32.0%. The health profile of the riverine population appears to differ from that of urban population in the Amazon. Additional risk factors for NCDs, such as environmental contamination and nutritional transition, may contribute more than increased genetic susceptibility to the prevalence of altered FBS and hypertension. Our results will help guide the development of preventive strategies and governmental actions for more effective management of NCDs in the Amazon area.

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.

Mercury Exposure, Blood Pressure, and Hypertension: A Systematic Review and Dose-response Meta-analysis

BACKGROUND

Body burden of mercury has been linked to hypertension in populations exposed to high mercury levels.

OBJECTIVES

We summarized, extracted, and pooled the results of published studies that investigated mercury biomarkers and hypertension or blood pressure (BP) measurements to examine this potential relationship.

METHODS

We searched PubMed, Embase, and TOXLINE and selected studies according to a priori defined inclusion criteria. Study quality was assessed by the Newcastle-Ottawa scale for cohort and case-control studies and the Quality Assessment Tool for cross-sectional studies. Study estimates were pooled using inverse-variance weighted random-effects models. Dose-response meta-analysis was performed with studies reporting hypertension and systolic BP for at least three mercury categories.

RESULTS

A total of 29 studies were included in the meta-analysis. The pooled odds ratio (OR) for hypertension, comparing the highest and lowest mercury exposure categories, was 1.35 [95% confidence interval (CI): 0.99, 1.83] for populations with hair mercury ≥2 μg/g in comparison with the OR of 1.12 (95% CI: 0.82, 1.52) for populations with hair mercury <2 μg/g. Positive associations were also observed for highest versus lowest mercury exposure categories on systolic and diastolic BP. Heterogeneity was observed for mercury species and exposure groups across different studies. Associations estimated using different mercury biomarkers generally agree with each other in the same study. A nonlinear dose-response relationship with an inflection point at 3 μg/g was identified, for both hypertension and systolic BP.

CONCLUSIONS

A significant positive association between mercury and hypertension and between mercury and BP was identified. The exposure dose is an important factor in determining the toxic effects of mercury on hypertension. https://doi.org/10.1289/EHP2863.

Hair as a Biomarker of Long Term Mercury Exposure in Brazilian Amazon: A Systematic Review

Many studies have assessed mercury (Hg) exposure in the Amazonian population. This article performs a literature search of the studies that used hair as a biomarker of Hg exposure in the Brazilian Amazonian population. The search covered the period from 1996 to 2016 and included articles which matched the following criteria: (1) articles related to Hg exposure into Brazilian Amazon; (2) articles that used hair as a biomarker of Hg exposure; (3) articles that used analytical tools to measure the Hg content on hair and (4) articles that presented arithmetic mean and/or minimum and maximum values of Hg. 36 studies were selected. The findings show that most of the studies were performed along margins of important rivers, such as Negro, Tapajós and Madeira. All the population presented mean levels of Hg on hair above 6 µg g^-1 and general population, adults, not determined and men presented levels of Hg on hair above 10 µg g^-1. The results show that most of the studies were performed by Brazilian institutions/researchers and the majority was performed in the State of Pará. The present study identified that Amazonian population has long-term been exposed to Hg. In terms of future perspectives, this study suggests the implementation of a strategic plan for environmental health surveillance in the region in order to promote health and benefit Amazonian population.

Arsenic, cadmium, and mercury-induced hypertension: mechanisms and epidemiological findings

Arsenic (As), cadmium (Cd), and mercury (Hg) are toxic elements widely distributed in the environment. Exposure to these elements was attributed to produce several acute and chronic illnesses including hypertension. The aim of this review is to provide a summary of the most frequently proposed mechanisms underlying hypertension associated with As, Cd, and Hg exposure including: oxidative stress, impaired nitric oxide (NO) signaling, modified vascular response to neurotransmitters and disturbed vascular muscle Ca²⁺ signaling, renal damage, and interference with the renin-angiotensin system. Due to the complexity of the vascular system, a combination rather than a singular mechanism needs to be considered. In addition, epidemiological findings showing the relationship between various biomarkers of metal exposure and hypertension are described. Given the complex etiology of hypertension, further epidemiological studies evaluating the roles of confounding factors such as age, gender, and life style are still necessary.

Reduction of soil erosion and mercury losses in agroforestry systems compared to forests and cultivated fields in the Brazilian Amazon

In addition to causing physical degradation and nutrient depletion, erosion of cultivated soils in the Amazon affects aquatic ecosystems through the release of natural soil mercury (Hg) towards lakes and rivers. While traditional agriculture is generally cited as being among the main causes of soil erosion, agroforestry practices are increasingly appreciated for soil conservation. This study was carried out in family farms of the rural Tapajós region (Brazil) and aimed at evaluating soil erosion and associated Hg release for three land uses. Soils, runoff water and eroded sediments were collected at three sites representing a land cover gradient: a recently burnt short-cycle cropping system (SCC), a 2-year-old agroforestry system (AFS) and a mature forest (F). At each site, two PVC soil erosion plots (each composed of three 2 × 5 m isolated subplots) were implemented on steep and moderate slopes respectively. Sampling was done after each of the 20 rain events that occurred during a 1-month study period, in the peak of the 2011 rain season. Runoff volume and rate, as well as eroded soil particles with their Hg and cation concentrations were determined. Total Hg and cation losses were then calculated for each subplot. Erosion processes were dominated by land use type over rainfall or soil slope. Eroded soil particles, as well as the amount of Hg and cations (CaMgK) mobilized at the AFS site were similar to those at the F site, but significantly lower than those at the SCC site (p < 0.0001). Erosion reduction at the AFS site was mainly attributed to the ground cover plants characterizing the recently established system. Moreover, edaphic change throughout AFS and F soil profiles differed from the SCC site. At the latter site, losses of fine particles and Hg were enhanced towards soil surface, while they were less pronounced at the other sites. This study shows that agroforestry systems, even in their early stages of implementation, are characterized by low erosion levels resembling those of local forest environments, thus contributing to the maintenance of soil integrity and to the reduction of Hg and nutrient mobility.

Toxicidad aguda de cloruro de mercurio (HGCL2) en Cachama blanca; <i>Piaractus brachypomus</i> (Cuvier, 1818)

La disposición inapropiada de sustancias que contienen mercurio puede causar toxicidad y acumulación en tejidos de peces. En el presente estudio se registra la concentración letal cincuenta (CL50) a 96 horas del mercurio para la cachama blanca [Piaractus brachypomus (Cuvier, 1818)]. Se calculó a través de una prueba semiestática de toxicidad aguda utilizando cloruro de mercurio (HgCl2) como fuente del metal. El experimento fue realizado en el Laboratorio de Toxicología de la Universidad del Tolima (Colombia), en condiciones controladas (28,09 ± 1,86 °C) y un fotoperiodo 12:12 (luz:oscuridad). Los alevinos (6,55 ± 1,3 g) fueron mantenidos en acuarios de vidrio con aireación constante, sin filtro y la alimentación fue suprimida 24 horas antes del inicio del experimento. Se emplearon 4 concentraciones de mercurio (Hg), con su respectiva replica, incluyendo un grupo control. Las concentraciones fueron: 0,45, 0,55, 0,65 y 0,75 mg Hg/l. Se realizó un análisis histopatológico con dos peces de cada tratamiento tomando muestras de branquias, cerebro y hígado. Los especímenes expuestos a las concentraciones más bajas (0,45 y 0,55 mg Hg/l) mostraron hiperactividad, a diferencia de los de las concentraciones más altas (0,65 y 0,75 mg Hg/l) los cuales evidenciaron disminución de su actividad. El análisis histopatológico mostró anomalías en branquias e hígado, como hiperplasia interlamelar y vaculizaciones lipídicas respectivamente, en respuesta a procesos de detoxificación. El valor de la CL50-96 h fue estimado utilizando el programa TSK (Trimmed-Spearman-Karber) y presentó un valor de 0,56 mg Hg/l. Este valor es cercano a lo registrado en otras especies de peces y representa el primer registro de toxicidad aguda para el mercurio en cachama blanca.

The Cut-off Value of Blood Mercury Concentration in Relation to Insulin Resistance

Background

Increased blood mercury concentration is associated with inflammation, and chronic inflammation can cause insulin resistance. We examined the cut-off value of blood mercury in relation to an increased score on the homeostasis model assessment for insulin resistance (HOMA-IR).

Methods

We used data from the Korean National Health and Nutrition Examination Survey (2008-2010). Relevant data from 5,184 subjects (2,523 men and 2,661 women) were analyzed cross-sectionally. General linear analysis was performed to evaluate the relationship between HOMA-IR score and blood mercury concentration. In addition, we determined the cut-off value of blood mercury concentration in relation to increased HOMA-IR score (> 2.34) using an ROC curve.

Results

The mean value of blood mercury concentration in men and women was 5.88 μg/L and 4.11 μg/L, respectively. In men, comparing to the first quartile, HOMA-IR score increased significantly in the third and fourth blood mercury quartiles. In women, however, the increase in HOMA-IR score was not significant. The cut-off value that best represented the association between increased HOMA-IR score and blood mercury concentration in men was found to be 4.71 μg/L.

Conclusion

Blood mercury concentration was associated with increased HOMA-IR score in men, and the cut-off value of blood mercury concentration that was correlated with increased HOMA-IR score was around 4.71 μg/L.

Methyl mercury, but not inorganic mercury, associated with higher blood pressure during pregnancy

Prior studies addressing associations between mercury and blood pressure have produced inconsistent findings; some of this may result from measuring total instead of speciated mercury. This cross-sectional study of 263 pregnant women assessed total mercury, speciated mercury, selenium, and n-3 polyunsaturated fatty acids in umbilical cord blood and blood pressure during labor and delivery. Models with a) total mercury or b) methyl and inorganic mercury were evaluated. Regression models adjusted for maternal age, race/ethnicity, prepregnancy body mass index, neighborhood income, parity, smoking, n-3 fatty acids and selenium. Geometric mean total, methyl, and inorganic mercury concentrations were 1.40µg/L (95% confidence interval: 1.29, 1.52); 0.95µg/L (0.84, 1.07); and 0.13µg/L (0.10, 0.17), respectively. Elevated systolic BP, diastolic BP, and pulse pressure were found, respectively, in 11.4%, 6.8%, and 19.8% of mothers. In adjusted multivariable models, a one-tertile increase of methyl mercury was associated with 2.83mmHg (0.17, 5.50) higher systolic blood pressure and 2.99mmHg (0.91, 5.08) higher pulse pressure. In the same models, an increase of one tertile of inorganic mercury was associated with -1.18mmHg (-3.72, 1.35) lower systolic blood pressure and -2.51mmHg (-4.49, -0.53) lower pulse pressure. No associations were observed with diastolic pressure. There was a non-significant trend of higher total mercury with higher systolic blood pressure. We observed a significant association of higher methyl mercury with higher systolic and pulse pressure, yet higher inorganic mercury was significantly associated with lower pulse pressure. These results should be confirmed with larger, longitudinal studies.

Mercury Exposure and Heart Diseases

Environmental contamination has exposed humans to various metal agents, including mercury. It has been determined that mercury is not only harmful to the health of vulnerable populations such as pregnant women and children, but is also toxic to ordinary adults in various ways. For many years, mercury was used in a wide variety of human activities. Nowadays, the exposure to this metal from both natural and artificial sources is significantly increasing. Recent studies suggest that chronic exposure, even to low concentration levels of mercury, can cause cardiovascular, reproductive, and developmental toxicity, neurotoxicity, nephrotoxicity, immunotoxicity, and carcinogenicity. Possible biological effects of mercury, including the relationship between mercury toxicity and diseases of the cardiovascular system, such as hypertension, coronary heart disease, and myocardial infarction, are being studied. As heart rhythm and function are under autonomic nervous system control, it has been hypothesized that the neurotoxic effects of mercury might also impact cardiac autonomic function. Mercury exposure could have a long-lasting effect on cardiac parasympathetic activity and some evidence has shown that mercury exposure might affect heart rate variability, particularly early exposures in children. The mechanism by which mercury produces toxic effects on the cardiovascular system is not fully elucidated, but this mechanism is believed to involve an increase in oxidative stress. The exposure to mercury increases the production of free radicals, potentially because of the role of mercury in the Fenton reaction and a reduction in the activity of antioxidant enzymes, such as glutathione peroxidase. In this review we report an overview on the toxicity of mercury and focus our attention on the toxic effects on the cardiovascular system.

Immunotoxicity of mercury: Pathological and toxicological effects

Mercury (Hg) is toxic and hazardous metal that causes natural disasters in the earth's crust. Exposure to Hg occurs via various routes; like oral (fish), inhalation, dental amalgams, and skin from cosmetics. In this review, we have discussed the sources of Hg and its potential for causing toxicity in humans. In addition, we also review its bio-chemical cycling in the environment; its systemic, immunotoxic, genotoxic/carcinogenic, and teratogenic health effects; and the dietary influences; as well as the important considerations in risk assessment and management of Hg poisoning have been discussed in detail. Many harmful outcomes have been reported, which will provide more awareness.

Toenail mercury and dyslipidemia: Interaction with selenium

BACKGROUND

Although compelling evidences from in vivo and in vitro studies exist, limited studies have examined the association between chronic mercury exposure and dyslipidemia. Particularly, data are sparse regarding the influence of selenium on this association of mercury with dyslipidemia in humans.

PURPOSE

The purpose of the current study was to examine the associations of toenail mercury with dyslipidemia and its components, and to examine whether selenium in toenails modifies these associations.

METHODS

We performed cross-sectional analyses using baseline data from a cohort in the Yeungnam area in South Korea, including 232 men and 269 women. Toenail mercury and selenium concentrations were quantified using neutron activation analysis, and fasting serum lipid measurements were obtained through the medical examination. Odds ratios of the prevalent hypercholesterolemia, hyper-LDL-cholesterolemia, hypo-HDL-cholesterolemia, hypertriglyceridemia, and dyslipidemia in correlation with mercury levels were calculated using multivariable logistic regression.

RESULTS

The mean levels of toenail mercury were 0.47μg/g for men and 0.34μg/g for women. After adjustment for multiple confounding variables, participants in the highest tertile of toenail mercury levels had 4.08 (95% CI 1.09-15.32, p for trend=0.02) times higher risk of hyper-LDL-cholesterolemia, and 2.24 (95% CI 1.15-4.37, p for trend=0.004) times higher risk of dyslipidemia than those in the lowest tertile. Selenium is a significant effect-modifier for these associations; the highest tertile of toenail mercury were significantly associated with a higher risk of hypercholesterolemia (OR 5.25, 95% CI 1.04-26.38) and dyslipidemia (OR 2.98, 95% CI 1.16-7.66) compared to the lowest tertile at toenail selenium levels ≤0.685μg/g, while these associations became weak and non-significant, showing OR 0.98 and 95% CI 0.25-3.80 for hypercholesterolemia and OR 1.99 and 95% CI 0.73-5.45 for dyslipidemia at toenail selenium levels >0.685μg/g.

DISCUSSION

We confirmed the beneficial effects of selenium against the harmful effects of mercury in humans with relatively high consumption of fish. Our finding has important implications in making dietary recommendations regarding optimal levels of fish and selenium intakes. Further studies are warranted to determine the appropriate level of fish consumption, considering both methylmercury and selenium exposure, in a larger prospective cohort or RCT.

Current progress on understanding the impact of mercury on human health

Mercury pollution and its impacts on human health is of global concern. The authors of this paper were members of the Plenary Panel on Human Health in the 12th International Conference on Mercury as a Global Pollutant held in Korea in June 2015. The Panel was asked by the conference organizers to address two questions: what is the current understanding of the impacts of mercury exposure on human health and what information is needed to evaluate the effectiveness of the Minamata Convention in lowering exposure and preventing adverse effects. The authors conducted a critical review of the literature published since January 2012 and discussed the current state-of-knowledge in the following areas: environmental exposure and/or risk assessment; kinetics and biomonitoring; effects on children development; effects on adult general populations; effects on artisanal and small-scale gold miners (ASGM); effects on dental workers; risk of ethylmercury in thimerosal-containing vaccines; interactions with nutrients; genetic determinants and; risk communication and management. Knowledge gaps in each area were identified and recommendations for future research were made. The Panel concluded that more knowledge synthesis efforts are needed to translate the research results into management tools for health professionals and policy makers.

An Investigation of Organic and Inorganic Mercury Exposure and Blood Pressure in a Small-Scale Gold Mining Community in Ghana

There is increasing concern about the cardiovascular effects of mercury (Hg) exposure, and that organic methylmercury and inorganic Hg²⁺ may affect the cardiovascular system and blood pressure differentially. In small-scale gold mining communities where inorganic, elemental Hg exposures are high, little is known about the effects of Hg on blood pressure. In 2011, we assessed the relationship between Hg exposure and blood pressure (BP) in a cross-sectional study of adults from a small-scale gold mining community, Kejetia, and subsistence farming community, Gorogo, in Ghana’s Upper East Region. Participants’ resting heart rate and BP were measured, and hair and urine samples were provided to serve as biomarkers of organic and inorganic Hg exposure, respectively. Participants included 70 miners and 26 non-miners from Kejetia and 75 non-miners from Gorogo. Total specific gravity-adjusted urinary and hair Hg was higher among Kejetia miners than Kejetia non-miners and Gorogo participants (median urinary Hg: 5.17, 1.18, and 0.154 µg/L, respectively; hair Hg: 0.945, 0.419, and 0.181 µg/g, respectively). Hypertension was prevalent in 17.7% of Kejetia and 21.3% of Gorogo participants. Urinary and hair Hg were not significantly associated with systolic or diastolic BP for Kejetia or Gorogo participants while adjusting for sex, age, and smoking status. Although our results follow trends seen in other studies, the associations were not of statistical significance. Given the unique study population and high exposures to inorganic Hg, the work contained here will help increase our understanding of the cardiovascular effects of Hg.