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

Mercury risk assessment scenarios: exposure from fish dietary behaviors of Katingan River Basin community

Katingan River has been contaminated by mercury from ASGM activities since the early 2000s. This study aims to assess the risk of mercury exposure from Katingan fish consumption and analyze relationships between exposure variables. We proposed two risk assessment scenarios based on mercury analysis of 74 fish samples and fish consumption questionnaire. The risk assessment result revealed that estimated daily intakes (EDIs) of Scenario 2 were generally 3-4 times higher than Scenario 1. The statistical test results showed significant differences (p < 0.05) in EDI values between scenarios, indicating that variations in fish consumption influenced the mercury intake. Three different health reference-based values (HRVs) were applied in estimating the hazard quotient (HQ) and it influenced the HQ results (p < 0.05), for both scenarios. The relationship analysis between variables presented a strong non-linear correlation between EDI and hair mercury level for both scenarios, but a weak relationship between age and hair mercury level.

"Hg distribution and accumulation in soil and vegetation in areas impacted by artisanal gold mining in the Southern Amazonian region of Madre de Dios, Peru."

Artisanal and small-scale gold mining (ASGM) is the primary global source of anthropogenic mercury (Hg) emissions. It has impacted the Amazon rainforest in the Peruvian region of Madre de Dios. However, few studies have investigated Hg's distribution in terrestrial ecosystems in this region. We studied Hg's distribution and its predictors in soil and native plant species from artisanal mining sites. Total Hg concentrations were determined in soil samples collected at different depths (0-5 cm and 5-30 cm) and plant samples (roots, shoots, leaves) from 19 native plant species collected in different land cover categories: naked soil (L1), gravel piles (L2), natural regeneration (L3), reforestation (L4), and primary forest (L5) in the mining sites. Hg levels in air were also studied using passive air samplers. The highest Hg concentrations in soil (average 0.276 and 0.210 mg kg-1 dw.) were found in the intact primary forest (L5) at 0-5 cm depth and in the plant rooting zones at 5-30 cm depth, respectively. Moreover, the highest Hg levels in plants (average 0.64 mg kg-1 dw) were found in foliage of intact primary forest (L5). The results suggest that the forest in these sites receives Hg from the atmosphere through leaf deposition and that Hg accumulates in the soil surrounding the roots. The Hg levels found in the plant leaves of the primary forest are the highest ever recorded in this region, exceeding values found in forests impacted by Hg pollution worldwide and raising concerns about the extent of the ASGM impact in this ecosystem. Correlations between Hg concentrations in soil, bioaccumulation in plant roots, and soil physical-chemical characteristics were determined. Linear regression models showed that the soil organic matter content (SOM), pH, and electrical conductivity (EC) predict the Hg distribution and accumulation in soil and bioaccumulation in root plants.

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.

Risk Assessment of Mercury-Contaminated Fish Consumption in the Brazilian Amazon: An Ecological Study

Mercury is one of the most dangerous contaminants on the planet. In recent years, evidence of mercury contamination in the Amazon has significantly increased, notably due to gold-mining activities. Although mercury contamination in fish has consistently been documented, little is known about the risk associated with fish consumption by populations in urban areas of the Amazon. We sampled 1010 fish sold in public markets in six state capitals and 11 additional cities. Mercury levels were determined for each specimen, and the evaluation of the health risks associated with consuming mercury-contaminated fish was conducted according to the methodology proposed by the World Health Organization (WHO). Our study reveals that more than one-fifth (21.3%) of the fish sold in urban centers had mercury levels above the safe limits (≥0.5 µg/g) established by the Brazilian Health Surveillance Agency (ANVISA). The prevalence of Hg contamination ≥0.5 µg/g was approximately 14 times higher in carnivorous than in noncarnivorous fish. The analysis of the risk attributable to fish consumption reveals that daily mercury intake exceeded the reference dose recommended by the U.S. EPA in all population groups analyzed, reaching up to 7 and 31 times in women of childbearing age and children from 2 to 4 years old, respectively. However, these risks are diverse depending on the type of fish consumed and must be considered to formulate appropriate nutritional guidelines for safe fish consumption by the local community.

Brazil's heavy metal pollution harms humans and ecosystems

This letter draws attention to the worrying situation of heavy metal pollution in Brazil, especially concerning the Amazon's Indigenous peoples affected by mercury contamination from illegal gold mining activities. Heavy metal pollution is also an emerging problem in other Brazilian biomes besides the Amazon Forest (e.g., Pampa biome in southern Brazil), as well as in coastal ecosystems/regions and large cities. Despite being a neglected problem, Brazil's heavy metal pollution causes significant detrimental impacts on human health and ecosystems. Finally, some alternatives to overcome this problem are suggested.

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.

Clinical Characteristics and Outcomes among Vaccinated and Unvaccinated Patients with Cardiovascular Disease Who Were Hospitalized for COVID-19 in Brazil: Retrospective Cohort

INTRODUCTION

COVID-19 in Brazil has already caused, and it still causes, several impacts on health, economy, and education. The risk factors for death involved those with cardiovascular diseases (CVD), which were prioritized for the vaccination of COVID-19.

OBJECTIVE

To investigate the clinical characteristics and outcomes between vaccinated and unvaccinated patients with cardiovascular diseases hospitalized for COVID-19 in Brazil in the year 2022.

METHODS

A retrospective cohort was analyzed from the year 2022, with cases being hospitalized by COVID-19 being drawn from SIVEP-GRIPE surveillance. We compared clinical characteristics, comorbidities, and outcomes between CVD carriers and non-carriers, and we also compared vaccinated with two doses vs. those that are unvaccinated in CVD carriers. We performed chi-square, odds ratio, logistic regression, and survival analysis.

RESULTS

We included, in the cohort, 112,459 hospital inpatients. An amount of 71,661 (63.72%) of the hospitalized patients had CVD. Regarding deaths, 37,888 (33.69%) died. Regarding vaccination against COVID-19, 20,855 (18.54%) people were not vaccinated with any dose among those with CVD. Death p- < 0.001 (OR 1.307-CI 1.235-1.383) and fever p- < 0.001 (OR 1.156-CI 1.098-1.218) were associated with the unvaccinated CVD carriers, and diarrhea p-0.015 (OR 1.116-CI 1.022-1.218), dyspnea p-0.022 (OR 1.074-CI 1.011-1.142), and respiratory distress p-0.021 (OR 1.070-CI 1.011-1.134) were also recorded. Those patients who possessed predictors of death, including invasive ventilation (p- < 0.001 (OR 8.816-CI 8.313-9.350)), were admitted to the ICU p- < 0.001 (OR 1.754-CI 1.684-1.827), and some had respiratory distress p- < 0.001 (OR 1.367-CI 1.312-1.423), dyspnea p < 0.001 (OR 1.341-CI 1.284-1.400), O₂ saturation < 95% p- < 0. 001 (OR 1.307-CI 1.254-1.363), they were unvaccinated against COVID-19 p- < 0.001 (OR 1.258-CI 1.200-1.319), they were of male sex p- < 0.001 (OR 1.179-CI 1.138-1.221), they had diarrhea p-0.018 (OR 1.081-CI 1.013-1.154), and they may have been old p < 0.001 (OR 1.034-CI 1.033-1.035). Survival was shorter for the unvaccinated p-0.003, and p- <0.001.

CONCLUSIONS

We highlight the predictors of death for those unvaccinated against COVID-19 in this research, and we evidenced the benefits of the COVID-19 vaccine in reducing deaths in hospitalized CVD patients.

Mercury Exposure in Women of Reproductive Age in Rondônia State, Amazon Region, Brazil

Environmental contamination by mercury (Hg) is a problem of global scale that affects human health. This study's aim was to evaluate Hg exposure among women of reproductive age residing in the Madeira River basin, in the State of Rondônia, Brazilian Amazon. This longitudinal cohort study used linear regression models to assess the effects on Hg levels of breastfeeding duration at 6 months, and of breastfeeding duration and number of new children at 2-year and 5-year. Breastfeeding duration was significantly associated with maternal Hg levels in all regression models (6 months, 2 years and 5 years) and no significant association was observed between the number of children and the change in maternal Hg levels in the 2-year and 5-year models. This longitudinal cohort study evaluated Hg levels and contributing factors among pregnant women from different communities (riverine, rural, mining and urban) in Rondônia, Amazon Region, for 5 years. A well-coordinated and designed national biomonitoring program is urgently needed to better understand the current situation of Hg levels in Brazil and the Amazon.

Uptake of Hg0(g) on TiO2, Al2O3, and Fe2O3 Nanoparticles: Importance in Atmospheric Chemical and Physical Processes

Mineral dust aerosols play an important role in tropospheric chemistry and aerosol-cloud interaction processes. Yet, their interactions with gaseous elemental mercury (Hg⁰_(g)) are not currently well understood. Using a coated-wall flow tube (CWFT) reactor, we measured the uptake of Hg⁰_(g) on some common components of mineral dust aerosols, including TiO₂, Al₂O₃, and Fe₂O₃, and the effects of irradiation (dark, visible and UV-A) and relative humidity (<2% to 60%) on the uptake kinetics. Under UV-A irradiation (320-400 nm) in dry air, we measured uptake coefficients (γ) equal to >1 × 10^-3 and (3 ± 1) × 10^-6 on TiO₂ and Al₂O₃, respectively. Under visible light irradiation (380-700 nm), Hg⁰_(g) uptake was only observed on TiO₂, with γ = (4 ± 3) × 10^-4. Raising the relative humidity inhibited the uptake on both TiO₂ and Al₂O₃, and the uptake coefficient at 60% RH for TiO₂ under UV-A irradiation was lower by ca. 3 orders of magnitude than dry conditions. Furthermore, we observed that water vapor induced the desorption of two distinct fractions from Hg-exposed surfaces via the displacement of weakly, physisorbed Hg and the photocatalyzed reduction of chemisorbed Hg. Based on the uptake coefficients from this report, we estimate that heterogeneous interactions with mineral dust may be significant under conditions with low relative humidity (<30%) and high dust loading masses. We herein discuss the implication of this study on understanding the life cycle analysis of atmospheric mercury in nature.

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.

Non-destructive mercury exposure assessment in the Brandt's hedgehog (Paraechinus hypomelas): spines as indicators of endogenous concentrations

Due to its persistence, bioaccumulation characteristics, and toxicity, environmental contamination with mercury (Hg) is of high concern for human health, living organisms, and ecosystems, and its biological monitoring is highly relevant. In this study, the levels of total Hg were measured in organs, tissues, and spines of 50 individuals of Brandt's hedgehog collected in Iran in 2019. The Hg median levels in kidneys, liver, muscle, and spines were 156, 47, 47, and 20 ng/g dry weight, respectively. The results showed a significant positive correlation between the levels of Hg in kidneys and liver (r = 0.519; p < 0.01) and in spines and muscle (r = 0.337, p < 0.01) and kidneys (r = 0.309, p < 0.05). Significant differences (p < 0.05) in Hg levels in organs and tissues were also observed depending on the sex, weight, length, and age of the individuals. In addition, the median levels of total Hg in kidneys of Brandt's hedgehogs from an agricultural ecotype (median 190 ± 65) were significantly higher (p < 0.05) than those collected from a forest ecotype (median 126 ± 50), suggesting that the habitat could have a significant impact on animal contamination.

Mercury Contamination: A Growing Threat to Riverine and Urban Communities in the Brazilian Amazon

In recent decades, widespread and uncontrolled use of mercury (Hg) in artisanal small-scale gold mining has released thousands of tons of mercury-contaminated waste in the Amazon biome, endangering the largest tropical rainforest worldwide. In this study, we assessed and compared blood Hg levels in individuals living in urban and riverine areas in the lower Tapajós basin and examined the association between Hg exposure and specific biochemical parameters. In total, 462 adults from eight riverine communities and one urban area were assessed. Overall, 75.6% of the participants exhibited Hg concentrations exceeding the safe limit (10 µg/L). Hg exposure was higher in the riverine population (90%) than in urban areas (57.1%). Mean Hg levels were 21.8 ± 30.9 µg/L and 50.6 µg/L in urban and riverine residents, respectively. The mean Hg level was higher in those aged 41–60 years in both urban and riparian areas, with riparian residents exhibiting a mean double that of urban residents. The highest glucose and hepatic biomarker levels were detected in the urban area, whereas the highest levels of renal biomarker occurred in the riverine population. Our results indicate that Hg contamination remains a persistent challenge for the urban population of Santarém, a major city in the Brazilian Amazon.

Methylmercury exposure during prenatal and postnatal neurodevelopment promotes oxidative stress associated with motor and cognitive damages in rats: an environmental-experimental toxicology study

The environmental contamination by methylmercury (MeHg) is a major concern for public health. The effects of MeHg in the central nervous system (CNS) of adult animals have been extensively investigated; however, little is known about the effects of MeHg exposure during intrauterine and lactation periods on motor and cognitive functions of adolescent rats. Therefore, this study aimed to investigate the effect of MeHg exposure during intrauterine life and lactation on both motor and cognitive functions of offspring rats. Ten female Wistar rats were exposed to 40 μg/kg/day of MeHg through cookie treats from the first day of pregnancy until the last day of breastfeeding. Both motor and cognitive functions of offspring male rats were assessed by open field, rotarod, and step-down inhibitory avoidance tests. Forty-one days after birth, the hippocampus and cerebellum were collected to determine total Hg content, antioxidant capacity against peroxyl radicals (ACAP), reduced glutathione (GSH) levels, lipid peroxidation (LPO), and nitrite levels. MeHg exposure during CNS development increased Hg levels in both hippocampal and cerebellar parenchymas, triggered oxidative stress throughout ACAP and GSH decrease, increased LPO and nitrite levels. These alterations resulted in reduced spontaneous and stimulated locomotion and short- and long-term memory deficits. Therefore, damages triggered by MeHg exposure during intrauterine life and lactation had detrimental effects on oxidative biochemistry and motor and cognitive functions of offspring rats.

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The MeHg exposure during CNS development increased mercury levels in hippocampal and cerebellar parenchyma.

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The MeHg intoxication during pregnancy and lactation impairs the redox status of hippocampus and cerebellum of the offspring.

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MeHg exposure causes behavioral effects in motor ability and cognition of offspring rats.

Uma revisão de escopo de revisões sistemáticas sobre exposição humana ao mercúrio

Resumo: Introdução: a promulgação da Convenção de Minamata no Brasil em 2018 incentivou o cumprimento dos seus objetivos em reduzir o uso e a poluição por mercúrio. Objetivo: caracterizar a produção científica sobre exposição humana ao mercúrio e identificar lacunas de conhecimento a fim de subsidiar a tomada de decisão em saúde. Métodos: revisão de escopo de revisões sistemáticas e metanálises, sem restrição de idioma ou data de publicação, utilizando as bases PubMed, BVS e Cochrane Library. Resultados: 71 estudos atenderam aos critérios de elegibilidade, com 40 revisões sistemáticas, 30 metanálises e 1 overview. Amálgama dentário e contaminação alimentar e ambiental por atividades que utilizam mercúrio foram as fontes de exposição mais mencionadas. Os temas mais estudados contaram com transtornos mentais e comportamentais, assim como uso de biomarcadores e testes neurocomportamentais relacionados à exposição ao mercúrio. Discussão: lacunas como a exposição ocupacional ao mercúrio, uso em práticas tradicionais e em cosméticos apontam para a necessidade de mais estudos. As revisões identificadas podem oferecer subsídios para sínteses de evidências e protocolos de atenção à saúde de populações expostas, assim como para a elaboração de políticas públicas que visem o controle do uso e da exposição ao mercúrio.

Innovative methods for remote assessment of neurobehavioral development

In response to the COVID-19 pandemic, research institutions across the globe have modified their operations in ways that have limited or eliminated the amount of permissible in-person research interaction. In order to prevent the loss of important developmentally-timed data during the pandemic, researchers have quickly pivoted and developed innovative methods for remote assessment of research participants. In this manuscript, we describe methods developed for remote assessment of a parent child cohort with a focus on examining the perinatal environment, behavioral and biological indicators of child neurobehavioral development, parent-child interaction, as well as parent and child mental and physical health. We include recommendations relevant to adapting in-laboratory assessments for remote data collection and conclude with a description of the successful dissemination of the methods to eight research sites across the United States, each of whom are involved in Phase 1 of the HEALthy Brain and Child Development (HBCD) Study. These remote methods were born out of pandemic-related necessity; however, they have much wider applicability and may offer advantages over in-laboratory neurodevelopmental assessments.

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.

Risk factors associated with the severity of COVID-19 in a region of the Brazilian Amazon

The Brazilian Northern region registered a high incidence of COVID-19 cases, particularly in the state of Pará. The present study investigated the risk factors associated with the severity of COVID-19 in a Brazilian Amazon region of 100,819 cases. An epidemiological, cross-sectional, analytical and demographic study, analyzing data on confirmed cases for COVID-19 available at the Brazilian Ministry of Health's surveillance platform, was conducted. Variables such as, municipalities of residence, age, gender, signs and symptoms, comorbidities were included and associated with COVID-19 cases and outcomes. The spatial distribution was performed using the ArcGIS program. A total of 100,819 cases were evaluated. Overall, patients had the mean age of 42.3 years, were female (51.2%) and with lethality reaching 4.79% of cases. Main symptoms included fever (66.5%), cough (61.9%) and sore throat (39.8%). Regarding comorbidities, most of the patients presented cardiovascular disease (5.1%) and diabetes (4.2%). Neurological disease increased risk of death by nearly 15 times, followed by obesity (5.16 times) and immunodeficiency (5.09 time). The municipalities with the highest incidence rate were Parauapebas, Canaã dos Carajás and Jacareacanga. Similarity between the Lower Amazon, Marajó and Southwest mesoregions of Pará state were observed concerning the highest morbidity rates. The obtained data demonstrated that the majority of cases occurred among young adults, females, with the classic influenza symptoms and chronic diseases. Finally, data suggest that the highest incidences were no longer in the metropolitan region of the state. The higher lethality rate than in Brazil may be associated with the greater impacts of the disease in this Amazonian population, or factors associated with fragile epidemiological surveillance in the notification of cases of cure.

An Assessment of Health Outcomes and Methylmercury Exposure in Munduruku Indigenous Women of Childbearing Age and Their Children under 2 Years Old

In line with the 1000-day initiative and the Sustainable Development Goals (SDG) 2 and 3, we present a cross-sectional analysis of maternal health, infant nutrition, and methylmercury exposure within hard-to-reach indigenous communities in the state of Pará, Brazilian Amazon. We collected data from all women of childbearing age (i.e., 12-49) and their infants under two years old in three Munduruku communities (Sawré Muybu, Sawré Aboy, and Poxo Muybu) along the Tapajos River. We explored health outcomes through interviews, vaccine coverage and clinical assessment, and determined baseline hair methylmercury (H-Hg) levels. Hemoglobin, infant growth (Anthropometric Z scores) and neurodevelopment tests results were collected. We found that 62% of women of childbearing age exceeded the reference limit of 6.0 μg/g H-Hg (median = 7.115, IQR = 4.678), with the worst affected community (Sawré Aboy) registering an average H-Hg concentration of 12.67 μg/g. Half of infants aged under 24 months presented with anemia. Three of 16 (18.8%) infants presented H-Hg levels above 6.0 µg/g (median: 3.88; IQR = 3.05). Four of the 16 infants were found to be stunted and 38% of women overweight, evidencing possible nutritional transition. No infant presented with appropriate vaccination coverage for their age. These communities presented with an estimated Infant Mortality Rate (IMR) of 86.7/1000 live births. The highest H-Hg level (19.6 µg/g) was recorded in an 11-month-old girl who was found to have gross motor delay and anemia. This already vulnerable indigenous Munduruku community presents with undernutrition and a high prevalence of chronic methylmercury exposure in women of childbearing age. This dual public health crisis in the context of wider health inequalities has the potential to compromise the development, health and survival of the developing fetus and infant in the first two critical years of life. We encourage culturally sensitive intervention and further research to focus efforts.

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.

Impacts of the Goldmining and Chronic Methylmercury Exposure on the Good-Living and Mental Health of Munduruku Native Communities in the Amazon Basin

This paper is an exploratory study that examines the illegal goldmining impacts on Munduruku communities' "Good-Living" (Xipan Jewewekukap) and explores the possible relationship between chronic methylmercury (MeHg) exposure and the worsening mental health conditions in three villages in the Middle-Tapajós River, Brazilian Amazon. The region has been experiencing a long-lasting threat of goldminers' invasions. A total of 109 people were interviewed and evaluated. Total mercury (THg) exposure levels were evaluated through hair samples analysis, from which MeHg exposure levels were calculated. The Geriatric Depression Scale-Short Form (GDS-SF) was used as a screening tool in order to assess mental health indicators. Brief non-structured interviews were carried out to investigate how goldmining is impacting the communities Good-Living. A Poisson regression model was used to estimate the possible association between mental health indicators (assessed through the GDS-SF) and the following independent variables: (i) mercury exposure level (<10.0 μg/g vs. ≥10.0 μg/g), (ii) self-reported nervousness, (iii) self-reported irritability, (iv) age group, and (v) monthly income. The analysis revealed high levels of mercury in hair samples (median: 7.4 µg/g, range 2.0-22.8; 70% and 28% of the participants had THg levels ≥6.0 and ≥10.0 µg/g, respectively) and pointed to a tendency in which higher levels of methylmercury exposure (Hg ≥ 10.0 µg/g) could be linked to worse mental health indicators. Although the GDS-SF has presented limitations due to the Munduruku sociocultural context, our findings suggest a tendency of worse mental health indicators in participants presenting high levels of MeHg exposure. Despite this limitation, the qualitative approach indicates an evident association between the impacts of goldmining and the Munduruku people's decreasing autonomy to maintain a Good-Living on their own terms, pointing to the importance of carrying out new investigations, especially considering longitudinal studies with qualitative methodologies and ethnographic approaches.

Genetic Polymorphism of Delta Aminolevulinic Acid Dehydratase (ALAD) Gene and Symptoms of Chronic Mercury Exposure in Munduruku Indigenous Children within the Brazilian Amazon

Genetic polymorphisms involved in mercury toxicokinetics and toxicodynamics may be associated with severe mercury toxicity. This study aimed to investigate the impact of an ALAD polymorphism on chronic mercury exposure and the health situation of indigenous children from the Brazilian Amazon. One-hundred-and-three indigenous children (under 15 years old) were included and genotyped (rs1800435) using a TaqMan validated assay. The mean age was 6.6 ± 4.5 years old, 60% were female, 49% presented with anemia, and the mean hair mercury concentration was 7.0 ± 4.5 (1.4-23.9) µg/g, with 49% exceeding the reference limit (≥6.0 µg/g). Only two children were heterozygous ALAD, while the others were all wild type. Minor allele frequency (ALAD G) and heterozygous genotype (ALAD CG) were 1% and 2%, respectively. The two children (12 and 14 years old) with the ALAD polymorphism had mercury levels above the average as well as had neurological symptoms related to chronic mercury exposure, such as visual field alterations, memory deficit, distal neuropathy, and toe amyotrophy. Both children also reported frequent consumption of fish in the diet, at least three times a week. In conclusion, our data confirm that an ALAD polymorphism can contribute to mercury half-life time, harmful effects, and neuropsychological disorders in indigenous children with chronic mercury exposure to gold mining activity.

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.

Methylmercury-Induced Toxicopathologic Findings in Salivary Glands of Offspring Rats After Gestational and Lactational Exposure

Methylmercury (MeHg) is one of the main global pollutants. The vulnerability of fetus and newborn to MeHg-induced changes is extensively reported, making relevant investigation possible for alternative sample matrix for human biological monitoring for at this stage of life. This study aimed to characterize tissue change effects of environmental-experimental MeHg on salivary glands of offspring rats after pre- and postnatal exposure. For this, pregnant Wistar rats were orally exposed to MeHg (40 μg/kg BW/day) or only vehicle (control group), from the gestational period to the end of the lactation period. Salivary glands (SG) were collected from the offspring to analyze possible Hg levels and main findings by histopathological evaluations and CK19 and α-SMA immunostaining. The results indicated that Hg levels in SG of intoxicated offspring were associated with histologic abnormalities, such as acinar atrophy and an increase in the intercellular matrix among the acini, as well as damages in the architecture of epithelium and myoepithelial cells, evidenced by a decrease in immunostaining area. Thus, this is the first study to show in the literature the toxicopathologic findings on SG of offspring after pre- and postnatal exposure to MeHg. Moreover, it presents the SG as an attractive target to futures studies, mainly in children exposed to environmentally relevant doses.

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.

Mercury and Prenatal Growth: A Systematic Review

The intrauterine environment is critical for healthy prenatal growth and affects neonatal survival and later health. Mercury is a toxic metal which can freely cross the placenta and disrupt a wide range of cellular processes. Many observational studies have investigated mercury exposure and prenatal growth, but no prior review has synthesised this evidence. Four relevant publication databases (Embase, MEDLINE/PubMed, PsycINFO, and Scopus) were systematically searched to identify studies of prenatal mercury exposure and birth weight, birth length, or head circumference. Study quality was assessed using the NIH Quality Assessment Tool, and results synthesised in a narrative review. Twenty-seven studies met the review criteria, these were in 17 countries and used 8 types of mercury biomarker. Studies of birth weight (total = 27) involving populations with high levels of mercury exposure, non-linear methods, or identified as high quality were more likely to report an association with mercury, but overall results were inconsistent. Most studies reported no strong evidence of association between mercury and birth length (n = 14) or head circumference (n = 14). Overall, our review did not identify strong evidence that mercury exposure leads to impaired prenatal growth, although there was some evidence of a negative association of mercury with birth weight.

RNA sequencing and proteomic profiling reveal different alterations by dietary methylmercury in the hippocampal transcriptome and proteome in BALB/c mice

Methylmercury (MeHg) is a highly neurotoxic form of mercury (Hg) present in seafood. Here, we recorded and compared proteomic and transcriptomic changes in hippocampus of male BALB/c mice exposed to two doses of MeHg. Mice were fed diets spiked with 0.28 mg MeHg kg-1, 5 mg MeHg kg-1, or an unspiked control diet for 77 days. Total mercury content was significantly (P < 0.05) increased in brain tissue of both MeHg-exposed groups (18 ± 2 mg Hg kg-1 and 0.56 ± 0.06 mg Hg kg-1). Hippocampal protein and ribonucleic acid (RNA) expression levels were significantly altered both in tissues from mice receiving a low dose MeHg (20 proteins/294 RNA transcripts) and a high dose MeHg (61 proteins/876 RNA transcripts). The majority but not all the differentially expressed features in hippocampus were dose dependent. The combined use of transcriptomic and proteomic profiling data provided insight on the influence of MeHg on neurotoxicity, energy metabolism, and oxidative stress through several regulated features and pathways, including RXR function and superoxide radical degradation.

Occupational human exposure to mercury in artisanal small-scale gold mining communities of Colombia

With the aim of protecting human life and the environment, the Minamata Convention seeks to reduce and monitor mercury (Hg) concentrations in the environment. Artisanal and Small-scale Gold Mining (ASGM) has been identified as the most important anthropogenic source of Hg at a global scale and an important route of human exposure to Hg. In this context, this study assessed total Hg (THg) in blood, urine and hair, and methylmercury (MeHg) in human hair samples from 238 participants with occupational exposure to Hg in the most relevant ASGM communities of Colombia. Mercury concentrations in different biological matrices were related to several variables of interest such as age, gender, body mass index, fish consumption, exposure time, and specific occupational activities, such as amalgamation and amalgam burning. The median values of THg in blood (3.70 µg/L), urine (4.00 µg/L) and hair (1.37 mg/kg), and hair MeHg (1.47 mg/kg) for all participants were below permissible concentrations set by WHO. However, about 40% of the miners showed Hg concentrations in blood, urine and/or hair above the WHO thresholds. In all the biological matrices studied, miners burning amalgams showed significantly higher concentrations than miners who did not burn amalgams, with values 7-, 7-, and 8-fold higher in blood, urine and hair, respectively. A multiple linear regression model revealed that burning amalgam and fish consumption were significant predictors of Hg exposure in miners. Miners from Guainía had the highest concentrations in urine and hair, most likely due to the high manipulation and burning of amalgam, and a high fish consumption. In contrast, miners from Caldas showed the lowest Hg concentrations in all the biomarkers because they do not manipulate or burn amalgam, as well as reporting the lowest fish consumption. Our study also highlighted that gold miners exposure to Hg depends on their work practices. Therefore, the implementation of a health education programme on gold mining strategies is required, especially in Guaina, Vaupés, Córdoba, and Antioquia departments.

Oral methylmercury intoxication aggravates cardiovascular risk factors and accelerates atherosclerosis lesion development in ApoE knockout and C57BL/6 mice

Methylmercury (MeHg) intoxication is associated with hypertension, hypercholesterolemia, and atherosclerosis by mechanisms that are not yet fully understood. We investigated the effects of MeHg intoxication in atherosclerosis-prone (ApoE-KO) and resistant C57BL/6 mice. Mice were submitted to carotid stenosis surgery (to induce atherosclerosis faster) and received water or MeHg solution (20 mg/L) for 15 days. Tail plethysmography was performed before and after MeHg exposure. Food and MeHg solution intakes were monitored weekly. On the 15th day, mice were submitted to intravital fluorescence microscopy of mesenteric vasculature to observe in vivo leukocyte rolling and adhesion. Results showed that despite the high hair and liver Hg concentrations in the MeHg group, food and water (or MeHg solution) consumption and liver function marker levels were similar to those in controls. MeHg exposure increased total cholesterol, the atherogenic (non-HDL) fraction and systolic and diastolic blood pressure. MeHg exposure also induced inflammation, as seen by the increased rolling and adhered leukocytes in the mesenteric vasculature. Atherosclerosis lesions were more extensive in the aorta and carotid sites of MeHg-ApoE knockout mice. Surprisingly, MeHg exposure also induced atherosclerosis lesions in C57BL/6 mice, which are resistant to atherosclerosis formation. We concluded that MeHg intoxication might represent a risk for cardiovascular diseases since it accelerates atherogenesis by exacerbating several independent risk factors.

Methylmercury in Predatory and Non-predatory Fish Species Marketed in the Amazon Triple Frontier

This study assessed if the concentrations of methylmercury (MeHg) in predatory and non-predatory fish caught in the Upper Solimões River are safe for human consumption, according to the reference values established by the Joint FAO/WHO Expert Committee on Food Additives (JECFA). MeHg concentrations were evaluated in muscle of 5 predatory and 4 non-predatory fish species by gas chromatography with electron capture detector (GC-ECD). MeHg concentrations in predatory (0.09 mg kg^-1) and non-predatory (0.04 mg kg^-1) fish were under the safe upper limit for human consumption. The general average concentration of MeHg in these fish were 0.05 mg kg^-1. The Estimated Weekly Intake of MeHg was higher than the provisional tolerable weekly intake in both predatory and non-predatory fish, especially for women. Due to the high rates of fish consumption in the Amazon, the risk assessment based only on the concentration of MeHg in fish may not be accurate.

Proteomic approach underlying the hippocampal neurodegeneration caused by low doses of methylmercury after long-term exposure in adult rats

Methylmercury (MeHg) is an important toxicant that causes cognitive dysfunctions in humans. This study aimed to investigate the proteomic and biochemical alterations of the hippocampus associated with behavioural consequences of low doses of MeHg in a long-term exposure model, and to realistically mimic in vivo the result of human exposure to this toxicant. Adult Wistar male rats were exposed to a dose of MeHg at 0.04 mg kg-1 day-1 by gavage for 60 days. Total mercury (Hg) content was significantly increased in the hippocampal parenchyma. The increase in the Hg levels was capable of reducing neuron and astrocyte cell density in the CA1, CA3, hilus and dentate gyrus regions, increasing both malondialdehyde and nitrite levels and decreasing antioxidant capacity against peroxyl radicals. The proteomic analysis detected 1041 proteins with altered expression due to MeHg exposure, including 364 proteins with no expression, 295 proteins with de novo expression and 382 proteins with up- or down-regulated expression. This proteomic approach revealed alterations in pathways related to chemical synapses, metabolism, amino acid transport, cell energy, neurodegenerative processes and myelin maintenance. Therefore, even at low doses of MeHg exposure, it is possible to cause hippocampal damage in adult rats at many organisational levels, triggering oxidative stress and proteome misbalance, featuring a neurodegenerative process and culminating in long- and short-term memory and learning deficits.

Multiple metal concentrations and gestational diabetes mellitus in Taiyuan, China

BACKGROUND

The association between multiple metal concentrations and gestational diabetes mellitus (GDM) is poorly understood.

METHODS

A total of 776 women with GDM and an equal number of controls were included in the study. Concentrations of metals in participants' blood (nickel (Ni), arsenic (As), cadmium (Cd), antimony (Sb), thallium (Tl), mercury (Hg), lead (Pb)) were measured using inductively coupled plasma-mass. We used unconditional logistical regression models to estimate the associations between metals and GDM. We also employed weighted quantile sum (WQS) regression and principal components analysis (PCA) to examine metal mixtures in relation to GDM.

RESULTS

An increased risk of GDM was associated with As (OR = 1.49, 95% CI: 1.11, 2.01 for the 2nd tertile vs. the 1st tertile) and Hg (OR = 1.43, 95% CI: 1.09, 1.88 for the 3rd tertile vs. the 1st tertile). In WQS analysis, the WQS index was significantly associated with GDM (OR = 1.20, 95% CI: 1.02, 1.41). The major contributor to the metal mixture index was Hg (69.2%), followed by Pb (12.8%), and As (11.3%). Based on PCA, the second principal component, which was characterized by Hg, Ni, and Pb, was associated with an increased risk of GDM (OR = 1.46, 95% CI: 1.02, 2.08 for the highest quartile vs. the lowest quartile).

CONCLUSIONS

Our study results suggest that high metal levels are associated with an increased risk of GDM, and this increased risk is mainly driven by Hg and, to a lesser extent, by Ni, Pb, and As.