Hair mercury levels in Amazonian populations: spatial distribution and trends

Long-Term Environmental Methylmercury Exposure Is Associated with Peripheral Neuropathy and Cognitive Impairment among an Amazon Indigenous Population

Widespread contamination of the Amazon basin with mercury has been reported to occur since at least the mid-80s due to heavy gold mining activity. Although initial studies have indicated that this may lead to deleterious neurological consequences to the indigenous populations living in the region, further research is needed to better characterize the neurological burden of such long-term exposure. With this aim, a cross-sectional exploratory study has been conducted with the Yanomami indigenous population residing in a northern Amazon region. All participants underwent a structured interview; detailed neurological examination, including assessment for cognitive, motor, coordination, and sensory functions; and laboratorial testing for serum hemoglobin, blood glucose, and methylmercury levels in hair samples. This study enrolled 154 individuals of 30.9 ± 16.8 years of age, of which 56.1% were female. Mean methylmercury levels in hair were 3.9 ± 1.7 µg/g. Methylmercury levels in hair > 6.0 µg/g were found in 10.3%. Among participants with hair methylmercury levels ≥ 6.0 μg/g, the prevalences of peripheral neuropathy and reduced cognitive performance were, respectively, 78.8% (95%CI 15-177%, p = 0.010) and 95.9% (95%CI 16-230.8%, p = 0.012) higher than those of individuals with lower levels. These results suggest that chronic mercury exposure may lead to significant and potentially irreversible neurotoxicity to Yanomami population living in the northern Amazon basin.

Trace element accumulation in different edible fish species from the Bolivian Amazon and the risk for human consumption

Artisanal mining and erosion of metalbearing soils can contaminate aquatic ecosystems and affect the health of riparian human populations, through metal bio-accumulation processes and fish consumption. Concentrations of eight trace metals (Cd, Cr, Co, Cu, Pb, Hg, Ni, Zn) and a metalloid (As) were measured in the muscle tissue of different edible fish species collected from markets of two cities along the Beni River banks, in the Bolivian Amazon. Relationships between the size of fish belonging to different trophic levels (carnivores, omnivores, detritivores and herbivorous) from four different fishing zones were analyzed. The most relevant results corresponded to the detritivore group, whose members exhibited significant positive correlations between the fish size and the concentration of three metals (cadmium, cobalt and nickel). Furthermore, a 3 × 3 scenario-risk analysis was performed to assess local risk for human health. This was done by relating three different scenarios of local fish consumption collected from literature (maximum, average and minimum) and three different levels of trace element concentrations (95th, 50th and 5th percentile) derived from the present study and the Minimal Risk Levels suggested by the Agency for Toxic Substances and Disease Registry. Results of these calculations determined the amount of fish muscle per contaminant that could be consumed per day without risking human's health. Finally, Target Hazard Quotients were calculated for each trace element, aiming to indicate the potential exposure to each one and the concentration at which no adverse effects are expected. The obtained results made clear that mercury is the only trace element that represents an important health risk to humans within the studied region, considering most of the combinations in the 3 × 3 analysis. Chronic mercury intoxication could occur when consumption of fish in Riberalta or Rurrenabaque exceeded 83 g/day in females and 110 g/day in males.

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.

Mercury in blood, hair, and feces from subsistence fish-eating riverines of the Madeira River Basin (Western Amazon)

BACKGROUND

The Madeira River (Amazon Basin) has been impacted by activities related to artisanal and small-scale gold mining (ASGM), deforestation and burning (for timber, agriculture, and hydroelectric dam projects). All these activities contribute to environmental mercury (Hg) release and cycling into the Amazon ecosystem and thus to changing lifestyles.

METHOD

We assessed exposure to total and MeHg in two small riverine communities of the Madeira River (Amazon): Lago Puruzinho (LP, n = 26 families) and São Sebastião do Tapurú (SST, n = 31 families). Samples of human hair (n = 137), blood (n = 39), and feces (n = 41) were collected from adults and children (0-15 years of age).

RESULTS

In women of childbearing age from LP village, the mean blood total-Hg (THg) (45.54 ± 24.76 μg.L^-1) and MeHg (10.79 ± 4.36 μg.L^-1) concentrations were significantly (p = 0.0024; p < 0.0001, respectively) higher than in women from SST village (THg: 25.32 ± 16.75 μg.L^-1; MeHg: 2.32 ± 1.56 μg.L^-1) village; the trend in hair-Hg persisted but was statistically significant (p < 0.0145) only for THg (LP, 11.34 ± 5.03 μg. g^-1; SST, 7.97 ± 3.51 μg. g^-1). In women, the median hair:blood ratio of total Hg was 269. In children, the mean hair THg concentrations were 6.07 ± 3.60 μg. g^-1 and 6.47 ± 4.16 μg. g^-1 in LP and SST; thus, not significantly different (p = 0.8006). There was a significant association (p < 0.001) between hair-Hg concentrations of mothers and their respective children. The excretion of Hg in feces of women (0.52 μg. g^-1 dw) was not significantly different from children (0.49 μg. g^-1 dw). The only statistically significant correlation between Hg in feces and in hair was found in children, (n = 16, r_s = 0.38, p = 0.005). Significant relationship was seen between the levels of THg in blood and hair of women from LP and SST. Based on hair-Hg concentrations, fish consumption rate ranged from 94.5 to 212.3 g.day^-1.

CONCLUSION

Women and children excrete THg in feces in comparable concentrations. However, the mean fish consumption rate and blood MeHg are higher in the most remote villagers. Mother`s hair-Hg concentration is a good predictor of children's hair-Hg.

Sources and Toxicity of Mercury in the San Francisco Bay Area, Spanning California and Beyond

This report synthesizes and evaluates published scientific literature on the environmental occurrence and biomagnification of mercury with emphasis on the San Francisco Bay Area (SFBA), California. Mercury forms various compounds, well known for their toxicity in humans and environmental ecosystems. Elemental mercury is transported and distributed by air, water, and sediments. Through the metabolic processes of algae and bacteria, mercury is converted into organic compounds, such as methylmercury (MeHg), which then bioaccumulates up through trophic levels. In fish, it is found primarily in skeletal muscle, while in humans, the primary target organs are the brain and kidneys. Health concerns exist regarding bioaccumulation of mercury in humans. This paper reviews the known anthropogenic sources of mercury contamination, including atmospheric deposition through aerial transport from coal burning power plants, cement production, and residual contaminants of mercury from gold mining, as well as mercury-containing waste from silver amalgams emitted from dental offices into waterways. Although tools exist for measuring mercury levels in hair, breast milk, urine, blood, and feces in humans, current diagnostic tools are inadequate in measuring total mercury load, including deposited mercury in tissues. Additionally, insufficient attention is being paid to potential synergistic impacts of mercury interaction with multipliers such as lead, cadmium, and aluminum. We provide specific data on methylmercury concentrations at different trophic levels, followed by recommendations for reducing the level of mercury in the SFBA in order to protect the health of humans and other species.

Population-based dietary exposure to mercury through fish consumption in the Southern Peruvian Amazon

BACKGROUND

Mercury exposure related to artisanal and small-scale gold mining (ASGM) has raised environmental and public health concerns globally. Exposure to mercury, a potent neurotoxin that bioaccumulates in fish, is especially of concern to women of childbearing age (WCBA) and children in high-fish consuming populations. In Madre de Dios (MDD), Peru, an Amazon region with naturally occurring mercury and high ASGM activity, there is significant exposure concern among the mainly riverine, fish-consuming communities. The objective of this study was to conduct the first assessment of mercury exposure in a population-based sample of MDD, identify factors associated with elevated levels and compare the relationship between fish consumption and hair total mercury (H-THg) among persons living in ASGM affected and non-ASGM affected watersheds.

METHODS

Hair samples and household demographic surveys, including a module on fish consumption, were collected from 723 participants across 46 communities within 10 km of the Interoceanic Highway in MDD, who were previously enrolled in the first population-based study in MDD spanning areas affected and unaffected by ASGM. H-THg concentration (natural log transformed) was evaluated for association with independent demographic variables through multilevel multivariate regression models accounting for clustering among households and communities. Samples from canned fish available at local stores were also tested for total mercury.

RESULTS

Fish consumption (diversity and total consumed) varied spatially along the highway. 269 participants (37.2%) had elevated H-THg (>2.2 μg/g; median 1.60 μg/g; mean 2.24 μg/g), including 42.7% of WCBA and 20.0% of children under 5. Overall, H-THg was higher among people living in ASGM-affected areas. H-THg concentrations were strongly associated with fish consumption; however, in the multivariate models, household consumption of high trophic level fish was associated with elevated H-THg only in communities located in the ASGM-impacted watersheds. Similarly, the relationship between living in a household engaged in economic activities of fishing or Brazil nut harvesting was associated with higher H-THg, but only among households in the ASGM-affected area. In the non-ASGM affected areas, we observed a positive relationship between household daily fruit consumption and H-THg that was not observed in ASGM-affected areas.

CONCLUSION

Diet, residential location, and occupation are strong predictors of mercury exposure in Madre de Dios, Peru. Canned fish may represent a previously overlooked source of dietary Hg exposure in the region. In accordance with the Minamata Convention on Mercury, the significant environmental health concern of mercury exposure in ASGM areas demands policy and programmatic attention.

Mercury exposure, risk factors, and perceptions among women of childbearing age in an artisanal gold mining region of the Peruvian Amazon

Recent studies from the Madre de Dios region of Peru report elevated mercury exposure among the general population. Our objective was to assess mercury exposure, risk factors, risk perceptions, and knowledge among women of childbearing age, a population of concern due to risks to infant and fetal health. We collected hair samples and administered a survey among 200 women aged 18-49 years residing in Madre de Dios. Hair total mercury (THg) concentrations were analyzed in accordance with EPA Method 7473. Associations between exposures and potential risk factors were analyzed using generalized linear mixed models. Geometric mean hair THg concentration (±standard deviation) for all participants was 1.62 ± 2.54 μg/g (range: 0.01-30.12 μg/g), and 67 participants (33.5%) had concentrations above the 2.2 μg/g reference dose established by the World Health Organization (WHO). Higher exposure was significantly associated with higher fish consumption (p = 0.03) and less mercury knowledge (p < 0.0001), but not with age or educational attainment. Most participants (86.2%) expressed concern about mercury contamination, but few (26.2%) had knowledge of the health risks associated with exposure. Many residents consumed fish species previously found to have low mercury concentrations, but more than 25% of participants reported consuming fish species with high mercury concentrations. We did not observe cross-sectional differences in fish intake among women who were pregnant or breastfeeding at the time of data collection.

Oxidative Stress Levels Induced by Mercury Exposure in Amazon Juvenile Populations in Brazil

Oxidative stress can be induced by mercury (Hg) exposure, including through fish consumption (diet), leading to health risks. The objective of this study was to evaluate the association between oxidative stress biomarkers and dietary Hg exposure levels in riverine children and adolescents at Madeira River (RO/Brazil). Population from three riverine local communities presenting different fish consumption frequencies was sampled. Hg was determined in blood (ICP-MS) and glutathione (GSH); glutathione S-transferases (GST) and malondialdehyde (MDA) were determined in serum (spectrophotometry). Statistical analyses were performed using parametric and non-parametric tests. Multiple linear regression models and generalized additives models were also used to estimate the relationships between oxidative stress biomarkers and blood Hg. The juvenile riverine population from Cuniã RESEX presented the highest levels of oxidative stress and Hg levels in blood (GST = 27.2 (4.93) U/L, MDA = 1.69 (0.27) µmol/L, Hg = 20.6 (18.0) µg/L). This population also presented the highest frequency of fish consumption. The positive relation between Hg and GST and MDA, adjusted for individual characteristics, suggests an oxidative effect. This study shows the importance of oxidative stress biomarkers in the evaluation of dietary Hg exposure since initial and reversible metabolic changes were observed, enriching health risk assessments.

Burden of Mild Mental Retardation attributed to prenatal methylmercury exposure in Amazon: local and regional estimates

The gold rush in the Amazon Region caused an increase of mercury (Hg) levels in the environment, and, consequently, raised human exposure. Once released into aquatic systems, Hg could generate methylmercury (MeHg), an extremely toxic compound, which is accumulated through trophic chains. Several studies have provided evidences of the brain sensitivity to MeHg, as well as, of the fetus vulnerability during pregnancy. The main objective of this study was to estimate the Mild Mental Retardation (MMR) in Amazonian populations, caused by prenatal exposure to MeHg, using the methodology proposed by Poulin (2008), which quantifies the environmental burden of disease. The estimates of the MMR burden, attributed to prenatal MeHg exposure, were based on the calculation of Disability-Adjusted Life Years (DALY), which were obtained from MMR incidence rate in the studied populations. At the local level, the MMR incidence rate calculations were based on primary data of MeHg exposure of riverine women at childbearing age. The MMR incidence rate was equal to 5.96/1,000 infants, which would result in 2.0 IQ points loss in 34.31% of the newborns. The estimated DALY/1,000 infants was equal to 71.2, while the DALY was 576. For the regional estimates, different exposure scenarios were created. The calculated DALY varied from 3,256 to 65,952 per year.

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.

Community exposure and vulnerability to water quality and availability: a case study in the mining-affected Pazña Municipality, Lake Poopó Basin, Bolivian Altiplano

Assessing water sources for drinking and irrigation along with community vulnerability, especially in developing and rural regions, is important for reducing risk posed by poor water quality and limited water availability and accessibility. We present a case study of rural mining-agricultural communities in the Lake Poopó Basin, one of the poorest regions on the Bolivian Altiplano. Here, relatively low rainfall, high evaporation, salinization and unregulated mining activity have contributed to environmental degradation and water issues, which is a situation facing many Altiplano communities. Social data from 72 households and chemical water quality data from 27 surface water and groundwater sites obtained between August 2013 and July 2014 were used to develop locally relevant vulnerability assessment methodologies and ratings with respect to water availability and quality, and Chemical Water Quality Hazard Ratings to assess water quality status. Levels of natural and mining-related contamination in many waters (CWQHR ≥ 6; 78% of assessed sites) mean that effective remediation would be challenging and require substantial investment. Although waters of fair to good chemical quality (CWQHR ≤ 5; 22% of assessed sites) do exist, treatment may still be required depending on use, and access issues remain problematic. There is a need to comply with water quality legislation, improve and maintain basic water supply and storage infrastructure, build and operate water and wastewater treatment plants, and adequately and safely contain and treat mine waste. This study serves as a framework that could be used elsewhere for assessing and mitigating water contamination and availability affecting vulnerable populations.

Mercury levels and human health in the Amazon Basin

CONTEXT

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

OBJECTIVE

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

METHODS

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

RESULTS AND CONCLUSION

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

Protective effects of niacin against methylmercury-induced genotoxicity and alterations in antioxidant status in rats

This study investigates the potential beneficial effects of niacin (NA; vitamin B3) supplementation in rats chronically exposed to methylmercury (MeHg). Animals were randomly assigned to one of 4 groups (n = 6): Group I, control, received distilled water by gavage; Group II, received MeHg (100 µg/kg/d) by gavage; Group III, received NA (50 mg/kg/d) in drinking water; Group IV, received MeHg (100 µg/kg/d) by gavage + NA (50 mg/kg/d) in drinking water. Biochemical parameters levels of glucose, triglycerides, total cholesterol and fractions, and enzyme activities aspartate transaminase (AST) and alanine transaminase (ALT) were determined. Further, oxidative stress markers activity of glutathione peroxidase (GPx) and catalase (CAT) activity, as well as levels of reduced glutathione (GSH), malondialdehyde (MDA), and nitric oxide, were examined, and the comet assay was performed, using blood/plasma. Hg levels were measured in blood, brain, and kidneys of animals. Our results demonstrated that NA reduced adverse effects produced by MeHg. The mechanism underlying these effects appears to be related to the intrinsic antioxidant potential of NA. Considering the beneficial effects attributed to NA following MeHg exposure and that fish are the main source of both NA and MeHg, future studies need to evaluate the potential counteractive effect of NA against the adverse consequences of MeHg exposure in fish-eating populations.

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

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

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

BACKGROUND

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

OBJECTIVES

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

METHODS

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

RESULTS

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

CONCLUSION

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

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

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

Biomarkers of mercury exposure in the Amazon

Mercury exposure in the Amazon has been studied since the 1980s decade and the assessment of human mercury exposure in the Amazon is difficult given that the natural occurrence of this metal is high and the concentration of mercury in biological samples of this population exceeds the standardized value of normality established by WHO. Few studies have focused on the discovery of mercury biomarkers in the region's population. In this way, some studies have used genetics as well as immunological and cytogenetic tools in order to find a molecular biomarker for assessing the toxicological effect of mercury in the Amazonian population. Most of those studies focused attention on the relation between mercury exposure and autoimmunity and, because of that, they will be discussed in more detail. Here we introduce the general aspects involved with each biomarker that was studied in the region in order to contextualize the reader and add information about the Amazonian life style and health that may be considered for future studies. We hope that, in the future, the toxicological studies in this field use high technological tools, such as the next generation sequencing and proteomics skills, in order to comprehend basic questions regarding the metabolic route of mercury in populations that are under constant exposure, such as in the Amazon.

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

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

Fish consumption during pregnancy, mercury transfer, and birth weight along the Madeira River Basin in Amazonia

Birth weight can be a predictor of maternal health issues related to nutrition and environmental contaminants. Total hair mercury (HHg) concentration was studied as an indicator of both fish consumption and methylmercury exposure in mothers (and newborns) living in selected low income areas of the Madeira River basin, Amazonia, Brazil. This cohort study (n = 1,433) consisted of traditional riverines (n = 396), riverines who had moved to urban (n = 676) and rural (n = 67) settings, and tin miner settlers (n = 294). Median maternal HHg was significantly different (p = 0.00001) between riverine (12.1 µg·g⁻¹), rural (7.82 µg·g⁻¹), urban (5.4 µg·g⁻¹), and tin miner (4.5 µg·g⁻¹) groups studied. The same trend (of medians) was observed for newborns’ HHg which also showed significant differences between riverine (3.0 µg·g⁻¹), rural (2.0 µg·g⁻¹), urban (1.5 µg·g⁻¹), and tin miner (0.8 µg·g⁻¹) groups. The correlation between maternal and newborn HHg was statistically significant in the riverine (r = 0.8952; p = 0.0001), urban (r = 0.6744; p = 0.0001), and rural (r = 0.8416; p = 0.0001) groups but not in the mother-infant pairs in the tin miner group (r = 0.0638; p = 0.2752). Birth weight was significantly different among groups but did not show a pattern consistent with that of fish consumption (and HHg). A multiple regression analysis showed that only family income and gestational age had a significant impact on birth weight. Conclusions: Maternal HHg is an important biomarker of maternal fish consumption and of methylmercury exposure during pregnancy. However, in these Amazonian groups, only maternal education and gestational age seemed to affect birth weight positively.

Levels of Cd, Pb, As, Hg, and Se in hair of residents living in villages around Fenghuang polymetallic mine, southwestern China

Heavy metal levels in hair of residents living in villages around Fenghuang mine were investigated. Samples belonging to mine areas showed the highest values, with mean concentrations (mg kg(-1)) of 0.17 for Cd, 8.67 for Pb, 0.11 for As, 2.19 for Hg, and 0.64 for Se. Significant correlations (p < 0.01) were found between Cd-Pb, Cd-As, Pb-As, and Se-Hg. There is no significant difference in any of the elements among age groups. However, significant differences in Cd and Pb levels were found between genders. Results revealed that children and females were more susceptible to Cd and Pb exposure.

Hydroelectric reservoir inundation (Rio Madeira Basin, Amazon) and changes in traditional lifestyle: impact on growth and neurodevelopment of pre-school children

Objective

To assess the dependence on fish consumption of families and its impact on nutritional status and neurodevelopment of pre-school children.

Design

Cross-sectional study that measured children’s hair mercury (HHg) as an indicator of family fish consumption, growth (anthropometricZ-scores, WHO standards) and neurological (Gesell developmental scores (GDS)) development.

Setting

Traditional living conditions among families residing in the area adjacent to the Samuel Dam (Western Amazon) hydroelectric reservoir.

Subjects

Two hundred and forty-nine pre-school children (1–59 months of age) from families transitioning from the traditional Amazonian lifestyle.

Results

Family fish consumption was significantly correlated with children’s HHg concentration (Spearman’sr= 0·246,P< 0·0001); however, HHg had no significant association with growth (Z-scores). Overall, the prevalence of severe malnutrition, i.e. stunting (height-for-ageZ-score (HAZ) ≤ −3), underweight (weight-for-ageZ-score (WAZ) ≤ −3) and wasting (weight-for-heightZ-score (WHZ) ≤ −3) was 5·2 % (n13), 0 % and 0·8 % (n2), respectively. The prevalence of moderate stunting (HAZ ≥ −3 to ≤ −2), underweight (WAZ ≥ −3 to ≤ −2) and wasting (WHZ ≥ −3 to ≤ −2) was 8·8 % (n22), 2·4 % (n6) and 4·8 % (n12), respectively. Although 76 % of the children showed adequate GDS (>85), multiple regression analysis showed that fish consumption (as HHg) had no impact on GDS, but that some variables did interact significantly with specific domains (motor and language development).

Conclusions

The study showed that the families’ shift in fish consumption had no negative impact on the growth of young children and that ensuing methylmercury exposure has not been a noticeable neurodevelopmental hindrance.

Research into mercury exposure and health education in subsistence fish-eating communities of the Amazon basin: potential effects on public health policy

The neurotoxic effects of fish-methylmercury (meHg) consumed regularly are considered hazardous to fetuses and newborn infants; as a result fish consumption advisories are an important asset to control meHg exposure in affluent societies. These concerns are now part of health promotion programs for Amazon subsistence villagers. While urban dwellers in affluent societies can choose an alternative nutritious diet, traditional and subsistence communities are caught up in controversial issues and lifestyle changes with unintended health consequences. Traditional fish-eating populations of industrialized and non-industrialized regions may be exposed to different neurotoxic substances: man-made pollutants and environmentally occurring meHg. Additionally, in non-industrialized countries, pregnant women and infants are still being immunized with thimerosal-containing vaccines (TCVs) which degrade to ethylmercury (etHg). Therefore, the complexity involving fish-meHg associated with wild-fish choices and Hg exposure derived from TCVs is difficult to disentangle and evaluate: are villagers able to distinguish exposure to differently hazardous chemical forms of Hg (inorganic, fish-meHg, and injected etHg)? Is it possible that instead of helping to prevent a plausible (unperceived) fish-meHg associated neurocognitive delay we may inadvertently arouse panic surrounding Hg exposure and disrupt subsistence fish-eating habits (necessary for survival) and life-saving vaccination programs (required by public health authorities)? These questions characterize the incompleteness of information related on the various chemical forms of Hg exposure and the need to convey messages that do not disrupt nutritional balance and disease prevention policies directed at Amazonian subsistence communities.