Adult women's blood mercury concentrations vary regionally in the United States: association with patterns of fish consumption (NHANES 1999-2004)

Regional Variation in Human Exposure to Persistent Organic Pollutants in the United States, NHANES

We examined serum levels of persistent organic pollutants (POPs) among geographical regions of the United States as defined by the US Census Bureau. National Health and Nutrition Examination Survey (NHANES) data for adults aged 20 years and older are presented for selected survey periods between 1999 and 2010. From NHANES 1999 through 2004, dichlorodiphenyldichloroethylene (DDE) concentration levels were consistently higher among people living in the West than in the Midwest, Northeast, or South. In 2003-2010, perfluorinated compound concentrations tended to be highest in the South. The sum of 35 polychlorinated biphenyls (PCBs) congeners was significantly higher in the Northeast [GM: 189; 95% CI: 173-204 ng/g lipid] than the remaining regions. The regional differences in higher body burdens of exposure to particular POPs could be attributed to a variety of activities, including region-specific patterns of land use and industrial and agricultural chemical applications, as well as different levels of regulatory activity.

Dental associations with blood mercury in pregnant women

Objectives

There is curiosity concerning the source of mercury that is absorbed into the mother's blood and which may affect the developing fetus. This study therefore sets out to determine the extent to which dental amalgam (DA) may contribute to total blood mercury (TBHg) levels of pregnant women in the UK.

Methods

Whole blood samples and information on diet and socio‐demographic factors were collected from pregnant women (n = 4484) enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC). The whole blood samples were assayed for total mercury levels using inductively coupled plasma dynamic reaction cell mass spectrometry (ICP‐DRC‐MS), and the women were retrospectively asked about features of their dental care during the pregnancy. Linear regression was used to estimate the relative contributions of DA to TBHg levels (log‐transformed) based on R² values, compared to the results from dietary and socio‐demographic variables.

Results

The contribution to the variance of the mothers' TBHg levels by dental variables was 6.47%, a figure comparable to the 8.75% shown for seafood consumption in this population. Dietary and dental variables explained 20.16% of the variance, with socio‐demographic variables contributing only a further 3.40%. The number of amalgams in the mouth at the start of pregnancy accounted for most of the variance in dental variables.

Conclusions

Dental amalgam contributes a comparable amount of variance in TBHg to seafood consumption in this population. However, because the measures of DA exposure were imprecise, these findings are likely to be an underestimate. There is no evidence to date in the literature that fetal exposures to mercury from maternal DAs have adverse effects on the developing child, but long‐term studies are warranted.

Atlantic Bottlenose Dolphins (Tursiops truncatus) as A Sentinel for Exposure to Mercury in Humans: Closing the Loop

Mercury (Hg) is a ubiquitous global contaminant with important public health implications. Mercury is released from a variety of anthropogenic, industrial processes, enters the earth's atmosphere and is re-deposited onto the earth's surface in rainfall. Much of this Hg enters the oceans which cover the majority of the earth's surface. In the marine environment, inorganic Hg is converted to the most toxic form of the element, methylmercury, and biomagnified through the trophic levels of the food web. The bottlenose dolphin (Tursiops truncatus) is the apex predator in many estuarine and coastal ecosystems. Due to their long life span and trophic position, bottlenose dolphins bioaccumulate high concentrations of contaminants including Hg, thus making them an important sentinel species for ecosystem and public health. Bottlenose dolphins in Florida bioaccumulate high concentrations of Hg in their blood, skin and internal organs. The concentrations of Hg in blood and skin of bottlenose dolphins of the Indian River Lagoon, FL (IRL) are among the highest reported world-wide. In previous studies, we demonstrated associations between concentrations of total Hg in the blood and skin of IRL dolphins and markers of endocrine, renal, hepatic, hematologic and immune system dysfunction. The predominant manifestation of exposure to mercury in humans is neurotoxicity. During the 1950s and 1960s, residents of Minamata bay, Japan were exposed to high concentrations of methyl mercury as the result of ingestion of fish and shellfish that had become contaminated in this infamous environmental disaster. Affected adults had severe motor and sensory abnormalities often leading to death. Methyl mercury crosses the placenta during pregnancy. Children exposed in utero were born with multiple congenital anomalies and also suffered from neurologic disorders. Significantly, local cats that consumed Hg contaminated fish developed severe signs of neurotoxicity which led to their subsequent description as the "dancing cats of Minamata bay". Unfortunately, the cause of these strange manifestations in cats was not recognized in time to prevent hundreds of additional cases from occurring. More recent studies have shown that exposure to mercury as a result of seafood consumption during pregnancy may result in multiple cognitive and neurodevelopmental effects in children. The levels of mercury found in bottlenose dolphins and the health effects we identified alerted us to the possibility of an important public health hazard. The IRL occupies 40 percent of the east coast of Florida and is bordered by counties with approximately 2.5 million human inhabitants. Therefore, we hypothesized that local inhabitants in communities bordering the IRL could be at risk of exposure to Hg from the consumption of fish and shellfish. We measured hair Hg in 135 local residents and found a mean concentration of 1.53 µg/g which was higher than that from previous studies of sport fishermen and coastal residents in other states. Over 50% of participants had a hair Hg concentration which exceeded the U.S. EPA exposure guideline. Hair Hg concentration was directly related to the frequency of seafood consumption and to the proportion of fish and shellfish obtained from local recreational sources. This study clearly exemplifies the importance of an animal sentinel in identifying a public health hazard and is virtually unique in "closing the loop" between animal and human health.

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

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

Global prevalence and distribution of genes and microorganisms involved in mercury methylation

Mercury (Hg) methylation produces the neurotoxic, highly bioaccumulative methylmercury (MeHg). The highly conserved nature of the recently identified Hg methylation genes hgcAB provides a foundation for broadly evaluating spatial and niche-specific patterns of microbial Hg methylation potential in nature. We queried hgcAB diversity and distribution in >3500 publicly available microbial metagenomes, encompassing a broad range of environments and generating a new global view of Hg methylation potential. The hgcAB genes were found in nearly all anaerobic (but not aerobic) environments, including oxygenated layers of the open ocean. Critically, hgcAB was effectively absent in ~1500 human and mammalian microbiomes, suggesting a low risk of endogenous MeHg production. New potential methylation habitats were identified, including invertebrate digestive tracts, thawing permafrost soils, coastal "dead zones," soils, sediments, and extreme environments, suggesting multiple routes for MeHg entry into food webs. Several new taxonomic groups capable of methylating Hg emerged, including lineages having no cultured representatives. Phylogenetic analysis points to an evolutionary relationship between hgcA and genes encoding corrinoid iron-sulfur proteins functioning in the ancient Wood-Ljungdahl carbon fixation pathway, suggesting that methanogenic Archaea may have been the first to perform these biotransformations.

High mercury seafood consumption associated with fatigue at specialty medical clinics on Long Island, NY

We investigated the association between seafood consumption and symptoms related to potential mercury toxicity in patients presenting to specialty medical clinics at Stony Brook Medical Center on Long Island, New York. We surveyed 118 patients from April-August 2012 about their seafood consumption patterns, specifically how frequently they were eating each type of fish, to assess mercury exposure. We also asked about symptoms associated with mercury toxicity including depression, fatigue, balance difficulties, or tingling around the mouth. Of the 118 adults surveyed, 14 consumed high mercury seafood (tuna steak, marlin, swordfish, or shark) at least weekly. This group was more likely to suffer from fatigue than other patients (p = 0.02). Logistic regression confirmed this association of fatigue with frequent high mercury fish consumption in both unadjusted analysis (OR = 5.53; 95% CI: 1.40-21.90) and analysis adjusted for age, race, sex, income, and clinic type (OR = 7.89; 95% CI: 1.63-38.15). No associations were observed between fish intake and depression, balance difficulties, or tingling around the mouth. Findings suggest that fatigue may be associated with eating high mercury fish but sample size is small. Larger studies are needed to determine whether fish intake patterns or blood mercury tests warrant consideration as part of the clinical work-up in coastal regions.

Polyunsaturated fatty acid interactions and breast cancer incidence: a population-based case-control study on Long Island, New York

PURPOSE

Experimental studies demonstrate that ω-3 polyunsaturated fatty acids (PUFAs) inhibit inflammatory eicosanoids generated by ω-6 PUFAs. Epidemiologic studies on dietary ω-3 PUFA intake show consistent inverse associations with breast cancer incidence among Asian populations, where ω-3, relative to ω-6, intake is high. In contrast, associations are inconsistent among Western populations, where intake of ω-3, relative to ω-6, is low. We hypothesized that examining interactions between ω-3 and ω-6 would help elucidate the PUFA-breast cancer association in the United States.

METHODS

In a Long Island, New York, population-based study of 1463 breast cancer cases and 1500 controls, we estimated multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) using unconditional logistic regression to examine interactions between ω-3 and ω-6 intake.

RESULTS

We observed a super-additive interaction (relative excess risk due to interaction = 0.41; 95% confidence interval = 0.06-0.76) between ω-3 and ω-6 intake in association with breast cancer incidence, although the CIs for the joint exposure of low ω-3/high ω-6 compared to high ω-3/low ω-6 intake were wide (odds ratio = 1.20; 95% confidence interval = 0.85-1.69).

CONCLUSIONS

Breast cancer risk reduction may be possible for U.S. women with dietary consumption of higher ω-3, which has anti-inflammatory properties, in concert with lower ω-6, which induces inflammation. Replication from future U.S.-based investigations is needed.

Decadal Declines of Mercury in Adult Bluefish (1972-2011) from the Mid-Atlantic Coast of the U.S.A

Concentrations of total mercury were measured in muscle of adult bluefish (Pomatomus saltatrix) collected in 2011 off North Carolina and compared with similar measurements made in 1972. Concentrations of mercury decreased by 43% in the fish between the two time periods, with an average rate of decline of about 10% per decade. This reduction is similar to estimated reductions of mercury observed in atmospheric deposition, riverine input, seawater, freshwater lakes, and freshwater fish across northern North America. Eight other studies between 1973 and 2007 confirm the decrease in mercury levels in bluefish captured in the Mid-Atlantic Bight. These findings imply that (1) reductions in the release of mercury across northern North America were reflected rather quickly (decades) in the decline of mercury in adult bluefish; (2) marine predatory fish may have been contaminated by anthropogenic sources of mercury for over 100 years; and (3) if bluefish are surrogates for other predators in the Mid-Atlantic Bight, then a reduction in the intake of mercury by the fish-consuming public has occurred. Finally, with global emissions of mercury continuing to increase, especially from Asia, it is important that long-term monitoring programs be conducted for mercury in marine fish of economic importance.

Prenatal mercury concentration is associated with changes in DNA methylation at TCEANC2 in newborns

BACKGROUND

Human exposure to the widespread environmental contaminant mercury is a known risk factor for common diseases such as cancer, cardiovascular disease and neurological disorders through poorly characterized mechanisms. Evidence suggests mercury exposure may alter DNA methylation levels, but to date, the effects in early life on a genome-wide scale have not been investigated.

METHODS

A study sample of 141 newborns was recruited in Baltimore, MD, USA and total mercury and methylmercury were measured in cord blood samples. We quantified genome-wide DNA methylation data using CHARM 2.0, an array-based method, and used region-finding analyses to identify concentration-associated differentially methylated regions (DMRs). To test for replication of these identified DMRs in the pilot, or Vanguard, phase of the National Children's Study (NCS), we compared bisulfite-pyrosequenced DNA at candidate regions from 85 whole cord blood samples with matched first trimester maternal mercury concentration measures.

RESULTS

Total mercury concentration was associated with methylation at DMRs inside ANGPT2 and near PRPF18 genes [false discovery rate (FDR) < 0.05], as well as DMRs near FOXD2 and within TCEANC2 (FDR< 0.1) genes. Methylmercury concentration was associated with an overlapping DMR within TCEANC2 (FDR< 0.05). In NCS replication analyses, methylation levels at three of four cytosine-guanine DNA dinucleotides (CpG sites) within the TCEANC2 DMR were associated with total mercury concentration (P < 0.05), and this association was diminished after adjusting for estimated cell proportions.

CONCLUSIONS

Evidence for an association between mercury and DNA methylation at the TCEANC2 region was found, which may represent a mercury-associated shift in cord blood cell composition or a change in methylation within blood cell types. Further confirmatory studies are needed.

The influence of obesity on blood mercury levels for U.S. non-pregnant adults and children: NHANES 2007-2010

BACKGROUND

In animal studies obesity is associated with higher blood and tissue mercury concentrations; however human studies are lacking. Although the mechanism underlying this association is uncertain, obesity may alter the metabolism and distribution of methylmercury.

OBJECTIVES

We determined whether obesity influenced blood mercury levels, the majority of which was methylmercury, for U.S. non-pregnant adults (≥20 years) and children (2-19 years) after controlling for methylmercury intake through fish and shellfish consumption, and other confounders.

METHODS

We completed secondary data analysis of the National Health and Nutrition Examination Survey (NHANES) (2007-2010) for participants who consumed fish/shellfish within 24h of blood collection for mercury analysis. Weighted least squares regression models related blood mercury levels (the dependent variable) to methylmercury exposure (μg) from fish consumed in the previous 24h, body mass index (BMI) (for adults), BMI z-scores (for children), and other confounders.

RESULTS

In adjusted models, blood mercury levels were inversely correlated with BMI for adults [β, 95% confidence interval (CI)=-0.54 (-0.90, -0.18)]. For children, blood mercury levels were inversely correlated with BMI z-scores but the trend was not significant [β (95% CI)=-0.016 (-0.066, 0.035)]. When obese adults or children were compared with those who were overweight/normal weight, blood mercury averaged 22% lower for obese adults (95% CI: -33%, -8.2%), while blood mercury did not differ significantly for obese children [β (95% CI)=-1.7% (-31%, +39%)].

CONCLUSIONS

After adjusting for the main, if not exclusive, exogenous source of methylmercury exposure (through fish/shellfish intake) and other confounders, our results support potential changes in the metabolism, distribution or excretion of methylmercury with increasing BMI (for adults).

Inter- and independent effects of region and race/ethnicity on variety of fruit and vegetable consumption in the USA: 2011 Behavioral Risk Factor Surveillance System (BRFSS)

OBJECTIVE

(i) To estimate the independent and combined effects of race/ethnicity and region on the variety of fruits and vegetables consumed in the USA in 2011; and (ii) to assess whether and to what extent race/ethnicity and region may synergistically influence variety of fruit and vegetable consumption.

DESIGN

Cross-sectional analysis. Multivariate logistic regression predicted the likelihood of meeting fruit and vegetable variety indicators independently and in combination for each race/ethnicity and region. Interaction effects models were used to test for interaction effects between race/ethnicity and region on fruit and vegetable variety.

SETTING

The 2011 Behavioral Risk Factor Surveillance System (BRFSS).

SUBJECTS

The sample consisted of 275 864 adult respondents.

RESULTS

Fewer than half of respondents consumed fruit and all vegetable subcategories at least once weekly. The adjusted likelihood of meeting fruit and vegetable variety indicators varied significantly by race/ethnicity and region (P<0·05). Significant interactions between race/ethnicity and region were found for at least once weekly consumption of beans, orange vegetables, all vegetables, and fruit and all vegetables (P<0·05).

CONCLUSIONS

Our results reinforce previous findings that the variety of vegetable consumption is lacking and is particularly evident among some population subgroups, such as non-Hispanic blacks in the Midwest USA, who may benefit from targeted dietary interventions.

More than half of US youth consume seafood and most have blood mercury concentrations below the EPA reference level, 2009-2012

BACKGROUND

Consuming seafood has health benefits, but seafood can also contain methylmercury, a neurotoxicant. Exposure to methylmercury affects children at different stages of brain development, including during adolescence.

OBJECTIVE

The objective was to examine seafood consumption and blood mercury concentrations in US youth.

METHODS

In the 2009-2012 NHANES, a cross-sectional nationally representative sample of the US population, seafood consumption in the past 30 d and blood mercury concentrations on the day of examination were collected from 5656 youth aged 1-19 y. Log-linear regression was used to examine the association between frequency of specific seafood consumption and blood mercury concentration, adjusting for race/Hispanic origin, sex, and age.

RESULTS

In 2009-2012, 62.4% ± 1.4% (percent ± SE) of youth consumed any seafood in the preceding month; 38.4% ± 1.4% and 48.5% ± 1.5% reported consuming shellfish and fish, respectively. In 2009-2012, the geometric mean blood mercury concentration was 0.50 ± 0.02 μg/L among seafood consumers and 0.27 ± 0.01 μg/L among those who did not consume seafood. Less than 0.5% of youth had blood mercury concentrations ≥5.8 μg/L. In adjusted log-linear regression analysis, no significant associations were observed between frequency of breaded fish or catfish consumption and blood mercury concentrations, but frequency of consuming certain seafood types had significant positive association with blood mercury concentrations: high-mercury fish (swordfish and shark) [exponentiated β coefficient (expβ): 2.40; 95% CI: 1.23, 4.68]; salmon (expβ: 1.41; 95% CI: 1.26, 1.55); tuna (expβ: 1.38; 95% CI: 1.29, 1.45); crabs (expβ: 1.35; 95% CI: 1.17, 1.55); shrimp (expβ: 1.12; 95% CI: 1.05, 1.20), and all other seafood (expβ: 1.23; 95% CI: 1.17, 1.32). Age-stratified log-linear regression analyses produced similar results.

CONCLUSION

Few US youth have blood mercury concentrations ≥5.8 μg/L, although more than half of US youth consumed seafood in the past month.

Combined toxicity of amorphous silica nanoparticles and methylmercury to human lung epithelial cells

Exposure to the ambient particulate matters (PM) has been associated with the morbidity and mortality of cardiopulmonary diseases. Compared with coarse particles, ultrafine particles (UFP) absorb or condense higher concentration of toxic air pollutants and are easily inhaled into the lung. However, the combined effects of UFP and air pollutants on human health are still poorly understood. In this study, a co-exposure in vitro model of amorphous silica nanoparticles (nano-SiO2) and methyl mercury (MeHg) was established to investigate their combined effects and the potential joint action type. Lung adenocarcinoma cells (A549) were exposed to either nano-SiO2 or MeHg alone, or a combination of both. Factorial design was applied to analyze their potential joint action type. Higher interfacial energy was observed in the mixed solution of nano-SiO2 and MeHg. The intracellular content of both silicon and mercury in combination group were much higher than those in single exposure groups. In addition, the co-exposure of nano-SiO2 and MeHg enhanced the reactive oxygen species (ROS) generation, lipid peroxidation and reduced the activity of superoxide dismutase (SOD) and glutathione peroxidase (GSH-px). The excessive oxidative stress led to oxidative DNA damage as well as cellular apoptosis. Factorial design analysis demonstrated that additive and synergistic interactions were responsible for the combined toxicity of nano-SiO2 and MeHg.

Assessing metal exposures in a community near a cement plant in the Northeast U.S

Cement production is a major source of metals and metalloids in the environment, while exposures to metals and metalloids may impact human health in the surrounding communities. We recruited 185 participants living in the vicinity of a cement plant in the northeast U.S., and measured the levels of aluminum (Al), arsenic (As), cadmium (Cd), lead (Pb), mercury (Hg), and selenium (Se) in blood and Hg in hair samples from them. A questionnaire was used to assess potential sources of Hg exposure. Multivariate regressions and spatial analyses were performed to evaluate the relative importance of different routes of exposures. The metal concentrations in blood or hair samples of our study participants were comparable to the U.S. general or regional population. Smoking contributed significantly to Cd and Pb exposures, and seafood consumption contributed significantly to Hg and As exposures, while variables related to the cement plant were not significantly associated with metal concentrations. Our results suggest that our study population was not at elevated health risk due to metal exposures, and that the contribution of the cement plant to metal exposures in the surrounding community was minimal.

A longitudinal study of mercury exposure associated with consumption of freshwater fish from a reservoir in rural south central USA

Methylmercury (MeHg) exposure through fish consumption is a worldwide health concern. Saltwater fish account for most dietary MeHg exposure in the general U.S. population, but less is known about seasonal variations in MeHg exposure and fish consumption among millions of freshwater anglers. This longitudinal study examined associations between MeHg exposure and fish consumption in a rural, low-income population relying on a freshwater reservoir (Oklahoma, USA) for recreational and subsistence fishing. We interviewed 151 participants, primarily anglers and their families, seasonally for one year using 90-day recall food frequency questionnaires to assess general and species-specific fish consumption, and tested hair biomarker samples for total mercury (THg hair). Mean THg hair was 0.27 μg/g (n=595, range: 0.0044-3.1 μg/g), with 4% of participants above U.S. EPA's guideline for women of childbearing age and children. Mean fish consumption was 58 g/d (95% CI: 49-67 g/d), within the range previously reported for recreational freshwater anglers and above the national average. Unlike the general U.S. population, freshwater species contributed the majority of fish consumption (69%) and dietary Hg exposure (60%) among participants, despite relatively low THg in local fish. THg hair increased with fish consumption, age, and education, and was higher among male participants and the lowest in winter. Our results suggest that future studies of anglers should consider seasonality in fish consumption and MeHg exposure and include household members who share their catch. Efforts to evaluate benefits of reducing Hg emissions should consider dietary patterns among consumers of fish from local freshwater bodies.

Environmental exposures, socioeconomics, disparities, and the kidneys

Kidney disease disproportionately affects racial and ethnic minority populations, the poor, and the socially disadvantaged. The excess risk of kidney disease among minority and disadvantaged populations can only be partially explained by an excess of diabetes, hypertension, and poor access to preventive care. Disparities in the environmental exposure to nephrotoxicants have been documented in minority and disadvantaged populations and may explain some of the excess risk of kidney disease. High-level environmental and occupational exposure to lead, cadmium, and mercury are known to cause specific nephropathies. However, there is growing evidence that low-level exposures to heavy metals may contribute to the development of CKD and its progression. In this article, we summarize the excess risk of environmental exposures among minority and disadvantaged populations. We also review the epidemiologic and clinical data linking low-level environmental exposure to lead, cadmium, and mercury to CKD and its progression. Finally, we briefly describe Mesoamerican nephropathy, an epidemic of CKD affecting young men in Central America, which may have occupational and environmental exposures contributing to its development.

Kidney biomarkers associated with blood lead, mercury, and cadmium in premenopausal women: a prospective cohort study

Certain metals are harmful to the kidney and liver at high levels, but associations with functional biomarkers at low exposure levels among premenopausal women apparently has not been evaluated. Healthy, regularly menstruating women (n = 259) were followed for up to 2 menstrual cycles with up to 16 visits. Renal and liver biomarkers were measured in serum at each clinic visit. Cadmium (Cd), lead (Pb), and mercury (Hg) were measured in whole blood at baseline. Linear mixed models were adjusted for age, body mass index (BMI), race, average calories, alcohol intake, smoking, and cycle day. Median levels of Cd, Pb, and Hg were 0.31 μg/L, 0.88 μg/dl, and 1.1 μg/L, respectively. One-third of women had diminished glomerular filtration rate (eGFR) (<90 ml/min/1.73 m(2)). Each twofold increase in Cd was associated with a negative 4.9% change in blood urea nitrogen (BUN) and bilirubin. Each twofold rise in Pb was associated with decreased eGFR and increased creatinine. A twofold elevation in Hg was associated with higher protein and reduced alkaline phosphatase. In healthy, predominantly nonsmoking women, low levels of Cd, Pb, and Hg were associated with changes in select biomarkers of kidney and liver function.

Relationship between Blood Mercury Level and Risk of Cardiovascular Diseases: Results from the Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV) 2008-2009

Limited epidemiologic data is available regarding the cardiovascular effects of mercury exposure. The purpose of this study was to determine the relationship between mercury exposure from fish consumption and cardiovascular disease in a nationally representative sample of Korean adults using the Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV 2008~2009). Survey logistic regression models accounting for the complex sampling were used to estimate the odds ratios (OR) adjusted for fish consumption frequency, age, education, individual annual income, household annual income, body mass index (BMI), waist circumference (WC), alcohol consumption status, and smoking status. The mean blood mercury level in the population was 5.44 μg/L. Trends toward increased blood mercury levels were seen for increased education level (P=0.0011), BMI (P<0.0001), WC (P<0.0001), and fish (i.e., anchovy) consumption frequency (P=0.0007). The unadjusted OR for hypertension in the highest blood mercury quartile was 1.450 [95% confidential interval (CI): 1.106~1.901] times higher than that of the lowest quartile. The fish consumption-adjusted OR for hypertension in the highest blood mercury quartile was 1.550 (95% CI: 1.131~2.123) times higher than that of the lowest quartile, and the OR for myocardial infarction or angina in the highest blood mercury quartile was 3.334 (95% CI: 1.338~8.308) times higher than that of the lowest quartile. No associations were observed between blood mercury levels and stroke. These findings suggest that mercury in the blood may be associated with an increased risk of hypertension and myocardial infarction or angina in the general Korean population.

Intake of seafood in the US varies by age, income, and education level but not by race-ethnicity

Current US federal dietary guidance recommends regular consumption of seafood (fish + shellfish) to promote health; however, little is known about how well Americans meet the guideline, particularly population subgroups that may be at risk for inadequate intake. The purposes of this study were to describe the prevalence of seafood consumption and, among consumers, the amounts of seafood eaten by sex, age group, income and education level, and race-ethnicity. Data from 15,407 adults aged 19+ participating in the 2005-2010 National Health and Nutrition Examination Surveys were analyzed using methods to account for sporadic intake of seafood. Over 80% of Americans reported consuming any seafood over the past 30 days, 74% reported consuming fish, and 54% reported eating shellfish. The percentages varied by socio-demographic group. Younger age and lower income and education levels were associated with lower odds of being a seafood consumer (p < 0.0001). Among those who reported eating seafood, the average amount eaten of any seafood was 158.2 ± 5.6 g/week. Among seafood consumers, women and individuals of lower age and education levels consumed less seafood. Approximately 80%-90% of seafood consumers did not meet seafood recommendations when needs were estimated by energy requirements. A great deal of work remains to move Americans toward seafood consumption at current recommended levels.

Relationship between serum ferritin level and blood mercury concentration using data from the Korean national health and nutrition examination survey (2010-2012)

BACKGROUND

Studies on the association between serum ferritin levels (S-Ft) and blood mercury concentrations (B-Hg) are scarce. The objective of this study was to investigate the relationships between these two parameters using a large-scale nationwide representative sample of the Korean males.

METHOD

A nationwide cross-sectional study was conducted to examine the relationship between S-Ft and B-Hg in 2832 men over 19 years of age (aged 20-87 years), using data from the 2010-2012 Korean National Health and Nutrition Examination Survey. The odds ratios (ORs) and 95% confidence intervals (CIs) for high B-Hg (>75th percentile) were calculated across S-Ft quartiles using multiple logistic regression analyses.

RESULTS

Mean values of B-Hg gradually increased in accordance with the quartiles of S-Ft (P-trend<0.001). The odds ratio (95% CI) for high B-Hg with the doubling of S-Ft was 1.51 (1.25-1.84) after adjusting for age, fish/shellfish consumption, rice consumption, waist circumference, cigarette smoking, alcohol intake, regular exercise, blood pressure, fasting plasma glucose, triglyceride, and high-density lipoprotein cholesterol. Compared with the lowest quartiles of B-Hg, the ORs (95% CI) for high S-Ft in the 3rd and 4th quartiles were 2.09 (1.17-3.73) and 2.73 (1.55-4.79) after adjusting for the same co-variables.

CONCLUSION

We found a positive relationship between S-Ft and B-Hg in a representative population sample of Korean adult men. Our results suggested S-Ft as a tool for environmental Hg exposure assessment.

Fish and rapeseed oil consumption in infants and mothers: dietary habits and determinants in a nationwide sample in Germany

PURPOSE

Fish and rapeseed oil are major sources of omega-3 polyunsaturated fatty acids (n-3 PUFA) in complementary food, but little is known about current consumption in Germany.

METHODS

We conducted a nationwide consumer survey to assess the consumption habits of fish and rapeseed oil and their determining factors in 985 mother-child dyads in Germany.

RESULTS

One-fourth of infants ate fish as often as recommended, i.e. at least once per week. Half of the mothers stated that they mainly used rapeseed oil for self-prepared and/or commercial vegetable-potato-meat meals. In contrast, mothers more frequently met recommendations for fish consumption (41 %), but used rapeseed oil (34 %) less often for their own nutrition. Maternal eating behaviour was the most important predictor for both of these n-3 PUFA rich foods in infants' nutrition. In contrast to infants' fish consumption, rapeseed oil intake in infancy was found to be influenced by some further factors, i.e. mothers' social class and omega-3 knowledge, which were also key determinants of mothers' own fish and rapeseed oil consumption.

CONCLUSION

To promote fish with complementary feeding, programs should focus on families whose mothers rarely eat fish. Nutritional campaigns to improve omega-3 knowledge-especially focusing on lower social classes-could be effective in increasing rapeseed oil consumption, although these programs should be combined with environmental improvements as it has been already started through the use of rapeseed oil in commercial baby jars.

Fetal exposure to environmental neurotoxins in Taiwan

Mercury (Hg), lead (Pb), cadmium (Cd), and arsenic (As) are recognized neurotoxins in children that particularly affect neurodevelopment and intellectual performance. Based on the hypothesis that the fetal basis of adult disease is fetal toxic exposure that results in adverse outcomes in adulthood, we explored the concentrations of key neurotoxins (i.e., Hg, Pb, Cd, and As) in meconium to identify the risk factors associated with these concentrations. From January 2007 to December 2009, 545 mother-infant pairs were recruited. The geometric mean concentrations of Pb and As in the meconium of babies of foreign-born mothers (22.9 and 38.1 µg/kg dry weight, respectively) were significantly greater than those of babies of Taiwan-born mothers (17.5 and 33.0 µg/kg dry weight, respectively). Maternal age (≥30 y), maternal education, use of traditional Chinese herbs during pregnancy, and fish cutlet consumption (≥3 meals/wk) were risk factors associated with concentrations of key prenatal neurotoxins. The Taiwan government should focus more attention on providing intervention programs for immigrant mothers to help protect the health of unborn babies. Further investigation on how multiple neurotoxins influence prenatal neurodevelopment is warranted.

A comparison of temporal trends in United States autism prevalence to trends in suspected environmental factors

BACKGROUND

The prevalence of diagnosed autism has increased rapidly over the last several decades among U.S. children. Environmental factors are thought to be driving this increase and a list of the top ten suspected environmental toxins was published recently.

METHODS

Temporal trends in autism for birth years 1970-2005 were derived from a combination of data from the California Department of Developmental Services (CDDS) and the United States Individuals with Disabilities Education Act (IDEA). Temporal trends in suspected toxins were derived from data compiled during an extensive literature survey. Toxin and autism trends were compared by visual inspection and computed correlation coefficients. Using IDEA data, autism prevalence vs. birth year trends were calculated independently from snapshots of data from the most recent annual report, and by tracking prevalence at a constant age over many years of reports. The ratio of the snapshot:tracking trend slopes was used to estimate the "real" fraction of the increase in autism.

RESULTS

The CDDS and IDEA data sets are qualitatively consistent in suggesting a strong increase in autism prevalence over recent decades. The quantitative comparison of IDEA snapshot and constant-age tracking trend slopes suggests that ~75-80% of the tracked increase in autism since 1988 is due to an actual increase in the disorder rather than to changing diagnostic criteria. Most of the suspected environmental toxins examined have flat or decreasing temporal trends that correlate poorly to the rise in autism. Some, including lead, organochlorine pesticides and vehicular emissions, have strongly decreasing trends. Among the suspected toxins surveyed, polybrominated diphenyl ethers, aluminum adjuvants, and the herbicide glyphosate have increasing trends that correlate positively to the rise in autism.

CONCLUSIONS

Diagnosed autism prevalence has risen dramatically in the U.S over the last several decades and continued to trend upward as of birth year 2005. The increase is mainly real and has occurred mostly since the late 1980s. In contrast, children's exposure to most of the top ten toxic compounds has remained flat or decreased over this same time frame. Environmental factors with increasing temporal trends can help suggest hypotheses for drivers of autism that merit further investigation.

Assessment of dietary fish consumption in pregnancy: comparing one-, four- and thirty-six-item questionnaires

OBJECTIVE

Fish consumption influences a number of health outcomes. Few studies have directly compared dietary assessment methods to determine the best approach to estimating intakes of fish and its component nutrients, including DHA, and toxicants, including methylmercury. Our objective was to compare three methods of assessing fish intake.

DESIGN

We assessed 30 d fish intake using three approaches: (i) a single question on total fish consumption; (ii) a brief comprehensive FFQ that included four questions about fish; and (iii) a focused FFQ with thirty-six questions about different finfish and shellfish.

SETTING

Obstetrics practices in Boston, MA, USA.

SUBJECTS

Fifty-nine pregnant women who consumed ≤2 monthly fish servings.

RESULTS

Estimated intakes of fish, DHA and Hg were lowest with the one-question screener and highest with the thirty-six-item fish questionnaire. Estimated intake of DHA with the thirty-six-item questionnaire was 4·4-fold higher (97 v. 22 mg/d), and intake of Hg was 3·8-fold higher (1·6 v. 0·42 μg/d), compared with the one-question screener. Plasma DHA concentration was correlated with fish intake assessed with the one-question screener (Spearman r = 0·27, P = 0·04), but not with the four-item FFQ (r = 0·08, P = 0·54) or the thirty-six-item fish questionnaire (r = 0·01, P = 0·93). In contrast, blood and hair Hg concentrations were similarly correlated with fish and Hg intakes regardless of the assessment method (r = 0·35 to 0·52).

CONCLUSIONS

A longer questionnaire provides no advantage over shorter questionnaires in ranking intakes of fish, DHA and Hg compared with biomarkers, but estimates of absolute intakes can vary by as much as fourfold across methods.

Association of body burden of mercury with liver function test status in the U.S. population

The majority of mercury (Hg) exposure in the US population is from consumption of fish contaminated with methylmercury (MeHg). Since inorganic Hg is the predominant form excreted in the feces and urine, hepatic biotransformation is a critical step in its normal clearance. This study was set to test the hypothesis that compromised liver function is associated with body burden of Hg as indirectly reflected by Hg sampled in blood and urine. From the National Health and Nutrition Examination Survey (NHANES, 2003-2008), 3769 adults aged 20 years and above were selected for analysis. Hepatic function was inferred from the three standard serum liver-related enzyme activities, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and γ-glutamyltransferase (GGT). Multivariate regression models were used to examine the associations of interest. Although urinary Hg was significantly correlated with serum Hg, the blood-urinary Hg relationship was influenced by liver function, which is also a function of demographic and lifestyle factors (e.g., gender). Although the results were only marginally significant for examined enzymes (p=0.06-0.08), urinary Hg tended to be lower among subjects with elevated liver enzymes, as compared to those with normal enzyme measurements. Conversely, MeHg generally represents a higher fraction of the total circulating Hg among those with elevated liver enzyme levels, especially among participants with elevations in all three enzymes (p=0.01). In conclusion, this population-based study identified an association between liver function, serum Hg and urinary Hg. Urinalysis may not be the optimal approach to monitor Hg elimination toxicokinetics or Hg exposure, since the majority of Hg excretion is fecal and the fidelity of urinary excretion may depend on healthy liver function. Future prospective studies are warranted to expand these findings.

Prenatal mercury exposure and infant birth weight in the Norwegian Mother and Child Cohort Study

OBJECTIVE

To examine the association between calculated maternal dietary exposure to Hg in pregnancy and infant birth weight in the Norwegian Mother and Child Cohort Study (MoBa).

DESIGN

Exposure was calculated with use of a constructed database of Hg in food items and reported dietary intake during pregnancy. Multivariable regression models were used to explore the association between maternal Hg exposure and infant birth weight, and to model associations with small-for-gestational-age offspring.

SETTING

The study is based on data from MoBa.

SUBJECTS

The study sample consisted of 62 941 women who answered a validated FFQ which covered the habitual diet during the first five months of pregnancy.

RESULTS

Median exposure to Hg was 0·15 μg/kg body weight per week and the contribution from seafood intake was 88 % of total Hg exposure. Women in the highest quintile compared with the lowest quintile of Hg exposure delivered offspring with 34 g lower birth weight (95 % CI -46 g, -22 g) and had an increased risk of giving birth to small-for-gestational-age offspring, adjusted OR = 1·19 (95 % CI 1·08, 1·30). Although seafood intake was positively associated with increased birth weight, stratified analyses showed negative associations between Hg exposure and birth weight within strata of seafood intake.

CONCLUSIONS

Although seafood intake in pregnancy is positively associated with birth weight, Hg exposure is negatively associated with birth weight. Seafood consumption during pregnancy should not be avoided, but clarification is needed to identify at what level of Hg exposure this risk might exceed the benefits of seafood.

Mercury in fish and adverse reproductive outcomes: results from South Carolina

Background

Mercury is a metal with widespread distribution in aquatic ecosystems and significant neurodevelopmental toxicity in humans. Fish biomonitoring for total mercury has been conducted in South Carolina (SC) since 1976, and consumption advisories have been posted for many SC waterways. However, there is limited information on the potential reproductive impacts of mercury due to recreational or subsistence fish consumption.

Methods

To address this issue, geocoded residential locations for live births from the Vital Statistics Registry (1995–2005, N = 362,625) were linked with spatially interpolated total mercury concentrations in fish to estimate potential mercury exposure from consumption of locally caught fish. Generalized estimating equations were used to test the hypothesis that risk of low birth weight (LBW, <2,500 grams) or preterm birth (PTB, <37 weeks clinical gestation) was greater among women living in areas with elevated total mercury in fish, after adjustment for confounding. Separate analyses estimated term LBW and PTB risks using residential proximity to rivers with fish consumption advisories to characterize exposure.

Results

Term LBW was more likely among women residing in areas in the upper quartile of predicted total mercury in fish (odds ratio [OR] = 1.04; 95% confidence interval [CI]: 1.00-1.09) or within 8 kilometers of a river with a ‘do not eat’ fish advisory (1.05; 1.00-1.11) compared to the lowest quartile, or rivers without fish consumption restrictions, respectively. When stratified by race, risks for term LBW or PTB were 10-18% more likely among African-American (AA) mothers living in areas with the highest total fish mercury concentrations.

Conclusions

To our knowledge, this is the first study to examine the relationship between fish total mercury concentrations and adverse reproductive outcomes in a large population-based sample that included AA women. The ecologic nature of exposure assessment in this study precludes causal inference. However, the results suggest a need for more detailed investigations to characterize patterns of local fish consumption and potential dose–response relationships between mercury exposure and adverse reproductive outcomes, particularly among AA mothers.

Trends in blood mercury concentrations and fish consumption among U.S. women of reproductive age, NHANES, 1999-2010

BACKGROUND

Consumption of finfish and shellfish is the primary exposure pathway of methylmercury (MeHg) in the US. MeHg exposure in utero is associated with neurodevelopmental and motor function deficits. Regulations and fish advisories may contribute to decreased exposure to mercury over time.

OBJECTIVES

Combine fish tissue mercury (FTHg) concentrations and 1999-2010 NHANES blood mercury concentrations and fish consumption data to investigate trends in blood mercury concentrations, fish consumption, and mercury intake in women of reproductive age.

METHODS

Blood MeHg was calculated from the blood total and inorganic concentrations. Dietary datasets were combined to estimate 30-day fish consumption, then combined with FTHg concentrations to estimate mercury intake and mercury concentration in the fish consumed. Non-linear and logistic regression analyses were used to evaluate trends over time.

RESULTS

Regression analysis found NHANES 1999-2000 to have higher blood MeHg concentrations than the mean of the later releases (p<0.0001) and a positive quadratic trend since 2000 (p=0.004). No trend was observed in fish consumption amount or mercury intake. A decreasing trend was found in the ratio of mercury intake to fish consumed (p=0.04).

CONCLUSIONS

The analyses found blood MeHg concentrations in NHANES 1999-2000 to be significantly higher than the mean of the later releases. There was no trend in fish consumption amount across the study period. The analysis found a decreasing trend in the ratio of mercury intake to fish consumed, consistent with women shifting their consumption to fish with lower mercury concentrations.

Effect of low-level prenatal mercury exposure on neonate neurobehavioral development in China

BACKGROUND

This study aimed to assess the effects of low-level prenatal mercury exposure on neonate neurobehavioral development in China.

METHODS

In total, 418 mother-neonate pairs were included in the study. Maternal urine, hair, and blood samples and cord blood samples were used to document prenatal exposure to mercury. The Neonatal Behavioral Neurological Assessment was used to estimate neurobehavioral development in the neonates at 3 days of age.

RESULTS

Total mercury level was significantly higher in cord blood than that in maternal blood. A strong correlation was found between total mercury levels in maternal blood and those in cord blood (r = 0.7431; P < 0.0001). Trend analysis revealed that mothers who consumed more fish had higher blood and cord blood mercury levels (all P < 0.0001). Significant differences were also found between male and female cord blood mercury levels among groups with different fish consumption frequencies (all P < 0.0001). Cord blood mercury level was significantly associated with total Neonatal Behavioral Neurological Assessment scores (β = 0.03; standard error = 0.01; P = 0.0409), passive muscle tone (odds ratio = 1.07; 95% confidence interval = 1.12-1.13; P = 0.0071), and active muscle tone (odds ratio = 1.06; 95% confidence interval = 1.01-1.11; P = 0.0170) scores after adjustment, respectively.

CONCLUSIONS

Neonatal neurodevelopment was associated with prenatal exposure to mercury. Women with high mercury levels should avoid intake seafood excessively during pregnancy. Long-term effects of exposure to mercury on childhood development need to be further explored.

Methylmercury monitoring study in Karakuwacho peninsula area in Japan

Methylmercury (MeHg) is a worldwide concern owing to its adverse health effects. To explore MeHg exposure burdens and the potential contributing factors in different subpopulations in a peninsula area (Karakuwacho) in Japan, a cross-sectional survey was performed. This study included 189 individuals from 102 families. The geometric means of total hair mercury (THg) were 5.74, 3.78 and 2.37 μg/g for adult males, females and children, respectively, of which 56.5 %, 30.9 % and 12.9 % had hair THg exceeding 5 μg/g, respectively. Tuna and mackerel were the common fish species that were positively correlated with hair THg levels in different subpopulations (standardized coefficient ranged from 0.20 to 0.58, p < 0.05). Frequent consumption of these fish species and a large amount of fish intake are likely major contributors of MeHg exposure in this area. Local-scale risk evaluation and risk communication should be highlighted in future studies.

Population correlates of circulating mercury levels in Korean adults: the Korea National Health and Nutrition Examination Survey IV

Background

Prior studies focused on bioaccumulation of mercury (Hg) and on large, long-lived fish species as the major environmental source of Hg, but little is known about consumption of small-sized fish or about non-dietary determinants of circulating Hg levels. The purpose of this study was to evaluate whole blood mercury concentration (WBHg) and its major dietary and non-dietary correlates in Korean adults.

Methods

We analyzed cross-sectional data from 3,972 (male = 1,994; female = 1,978) participants who completed the Korean National Health and Nutrition Examination Survey IV, 2008 to 2009. Relevant factors included diet, geographic location of residence, demographics, and lifestyle. WBHg concentration was measured using cold-vapor atomic absorption spectrometry. Multivariable linear models assessed independent correlates of dietary and non-dietary factors for WBHg levels.

Results

Median levels of WBHg were 5.1 μg/L in men and 3.7 μg/L in women. Higher levels of fish/shellfish intake were associated with higher levels of WBHg. Higher consumption of small-sized fish was linked to higher levels of WBHg. Non-dietary predictors of higher WBHg were being male, greater alcohol consumption, higher income and education, overweight/obesity, increasing age, and living in the southeast region.

Conclusions

Both dietary and non-dietary factors were associated with WBHg levels in the Korean population. There is significant geographic variation in WBHg levels; residents living in the mid-south have higher WBHg levels. We speculate that uncontrolled geographic characteristics, such as local soil/water content and specific dietary habits are involved.

Seafood consumption and blood mercury concentrations in adults aged ≥20 y, 2007-2010

BACKGROUND

Seafood is part of a healthy diet, but seafood can also contain methyl mercury-a neurotoxin.

OBJECTIVE

The objective was to describe seafood consumption in US adults and to explore the relation between seafood consumption and blood mercury.

DESIGN

Seafood consumption, obtained from a food-frequency questionnaire, and blood mercury data were available for 10,673 adults who participated in the 2007-2010 NHANES-a cross-sectional nationally representative sample of the US population. Seafood consumption was categorized by type (fish or shellfish) and by frequency of consumption (0, 1-2, 3-4, or ≥5 times/mo). Linear trends in geometric mean blood mercury concentrations by frequency of seafood consumption were tested. Logistic regression analyses examined the odds of blood mercury concentrations ≥5.8 μg/L (as identified by the National Research Council) based on frequency of the specific type of seafood consumed (included in the model as continuous variables) adjusted for sex, age, and race/Hispanic origin.

RESULTS

In 2007-2010, 83.0% ± 0.7% (±SE) of adults consumed seafood in the preceding month. In adults consuming seafood, the blood mercury concentration increased as the frequency of seafood consumption increased (P < 0.001). In 2007-2010, 4.6% ± 0.39% of adults had blood mercury concentrations ≥5.8 μg/L. Results of the logistic regression on blood mercury concentrations ≥5.8 μg/L showed no association with shrimp (P = 0.21) or crab (P = 0.48) consumption and a highly significant positive association with consumption of high-mercury fish (adjusted OR per unit monthly consumption: 4.58; 95% CI: 2.44, 8.62; P < 0.001), tuna (adjusted OR: 1.14; 95% CI: 1.10, 1.17; P < 0.001), salmon (adjusted OR: 1.14; 95% CI: 1.09, 1.20; P < 0.001), and other seafood (adjusted OR: 1.12; 95% CI: 1.08, 1.15; P < 0.001).

CONCLUSION

Most US adults consume seafood, and the blood mercury concentration is associated with the consumption of tuna, salmon, high-mercury fish, and other seafood.

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

OBJECTIVE

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

METHODS

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

FINDINGS

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

CONCLUSION

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

Blood mercury concentrations in pregnant and nonpregnant women in the United States: National Health and Nutrition Examination Survey 1999-2006

BACKGROUND

Prenatal exposure to methylmercury is associated with adverse neurologic development in children. We examined total blood mercury concentrations and predictors of higher blood mercury concentrations in pregnant and nonpregnant women.

METHODS

We analyzed data from 1183 pregnant and 5587 nonpregnant women aged 16-49 years from the 1999-2006 National Health and Nutrition Examination Survey (NHANES). We estimated geometric mean blood mercury concentrations and characteristics associated with higher mercury concentrations (≥3.5 μg/L) in crude and adjusted linear and logistic regression models.

RESULTS

After adjusting for age and race/ethnicity, geometric mean blood mercury concentrations were clinically similar but significantly lower for pregnant (0.81 μg/L; 95% confidence interval [CI], 0.71-0.91) and nonpregnant women of childbearing age (0.93 μg/L; 95% CI, 0.87-0.99); 94% of pregnant and 89% of nonpregnant women had blood mercury concentrations below 3.5 μg/L. The most significant predictor of higher blood mercury concentrations for both pregnant and nonpregnant women was any seafood consumption vs no consumption in the last 30 days (odds ratio, 18.7; 95% CI, 4.9-71.1; odds ratio, 15.5; 95% CI, 7.5-32.1, respectively). Other characteristics associated with ≥3.5 μg/L blood mercury concentrations were older age (≥35 years), higher education (greater than high school), and higher family income to poverty ratio (3.501+) for both pregnant and nonpregnant women.

CONCLUSION

Pregnancy status was not strongly associated with blood mercury concentrations in women of childbearing age and blood mercury concentrations above the 3.5 μg/L cut were uncommon.

Association of cadmium, lead and mercury with paraoxonase 1 activity in women

BACKGROUND

The activity of paraoxonase 1 (PON1), an antioxidant enzyme whose polymorphisms have been associated with cancer risk, may be associated with metals exposure.

OBJECTIVE

To evaluate PON1 activity in relation to cadmium, lead, and mercury levels in healthy, premenopausal women.

METHODS

Women from upstate New York were followed for ≥ two menstrual cycles. Repeated measures linear mixed models estimated the association between cadmium, lead, and mercury levels (by tertile: T1, T2, T3) and PON1 arylesterase (PON1A) and PON1 paraoxonase (PON1P) activity, separately. Analyses were stratified by PON1 Q192R phenotype and un-stratified.

RESULTS

Median blood cadmium, lead, and mercury concentrations were 0.30 µg/L, 0.87 µg/dL, and 1.15 µg/L. In un-stratified analyses cadmium and mercury were associated with decreased PON1A activity (T2 vs. T1; not T3 vs. T1) but metals were not associated with PON1P. Phenotypes were distributed between QQ (n = 99), QR (n = 117), and RR (n = 34). Cadmium was associated with decreased PON1A activity for QR and RR phenotypes comparing T2 vs. T1 (-14.4% 95% confidence interval [CI] [-20.1, -8.4] and -27.9% [-39.5, -14.0],). Lead was associated with decreased PON1A (RR phenotype, T3 vs. T1 -18.9% [-32.5, -2.5]; T2 vs. T1 -19.6% [-32.4, -4.4]). Cadmium was associated with lower PON1P comparing T2 vs. T1 for the RR (-34.9% [-51.5, -12.5]) and QR phenotypes (-9.5% [-18.1, 0.0]) but not comparing T3 vs. T1. Cadmium was associated with increases in PON1P levels (QQ phenotype, T3 vs. T1 24.5% [7.0, 44.9]) and mercury was associated with increased PON1A levels (QQ phenotype, T3 vs. T1 6.2% [0.2, 12.6]). Mercury was associated with decreased PON1P (RR phenotype, T2 vs. T1 -22.8 [-37.8, -4.1]).

CONCLUSION

Blood metals were associated with PON1 activity and these effects varied by phenotype. However, there was not a linear dose-response and these findings await replication.

Community-wide health risk assessment using geographically resolved demographic data: a synthetic population approach

Background

Evaluating environmental health risks in communities requires models characterizing geographic and demographic patterns of exposure to multiple stressors. These exposure models can be constructed from multivariable regression analyses using individual-level predictors (microdata), but these microdata are not typically available with sufficient geographic resolution for community risk analyses given privacy concerns.

Methods

We developed synthetic geographically-resolved microdata for a low-income community (New Bedford, Massachusetts) facing multiple environmental stressors. We first applied probabilistic reweighting using simulated annealing to data from the 2006–2010 American Community Survey, combining 9,135 microdata samples from the New Bedford area with census tract-level constraints for individual and household characteristics. We then evaluated the synthetic microdata using goodness-of-fit tests and by examining spatial patterns of microdata fields not used as constraints. As a demonstration, we developed a multivariable regression model predicting smoking behavior as a function of individual-level microdata fields using New Bedford-specific data from the 2006–2010 Behavioral Risk Factor Surveillance System, linking this model with the synthetic microdata to predict demographic and geographic smoking patterns in New Bedford.

Results

Our simulation produced microdata representing all 94,944 individuals living in New Bedford in 2006–2010. Variables in the synthetic population matched the constraints well at the census tract level (e.g., ancestry, gender, age, education, household income) and reproduced the census-derived spatial patterns of non-constraint microdata. Smoking in New Bedford was significantly associated with numerous demographic variables found in the microdata, with estimated tract-level smoking rates varying from 20% (95% CI: 17%, 22%) to 37% (95% CI: 30%, 45%).

Conclusions

We used simulation methods to create geographically-resolved individual-level microdata that can be used in community-wide exposure and risk assessment studies. This approach provides insights regarding community-scale exposure and vulnerability patterns, valuable in settings where policy can be informed by characterization of multi-stressor exposures and health risks at high resolution.

A method to screen U.S. environmental biomonitoring data for race/ethnicity and income-related disparity

BACKGROUND

Environmental biomonitoring data provide one way to examine race/ethnicity and income-related exposure disparity and identify potential environmental justice concerns.

METHODS

We screened U.S. National Health and Nutrition Examination Survey (NHANES) 2001-2008 biomonitoring data for 228 chemicals for race/ethnicity and income-related disparity. We defined six subgroups by race/ethnicity-Mexican American, non-Hispanic black, non-Hispanic white-and income-Low Income: poverty income ratio (PIR) <2, High Income: PIR ≥ 2. We assessed disparity by comparing the central tendency (geometric mean [GM]) of the biomonitoring concentrations of each subgroup to that of the reference subgroup (non-Hispanic white/High Income), adjusting for multiple comparisons using the Holm-Bonferroni procedure.

RESULTS

There were sufficient data to estimate at least one geometric mean ratio (GMR) for 108 chemicals; 37 had at least one GMR statistically different from one. There was evidence of potential environmental justice concern (GMR significantly >1) for 12 chemicals: cotinine; antimony; lead; thallium; 2,4- and 2,5-dichlorophenol; p,p'-dichlorodiphenyldichloroethylene; methyl and propyl paraben; and mono-ethyl, mono-isobutyl, and mono-n-butyl phthalate. There was also evidence of GMR significantly <1 for 25 chemicals (of which 17 were polychlorinated biphenyls).

CONCLUSIONS

Although many of our results were consistent with the U.S. literature, findings relevant to environmental justice were novel for dichlorophenols and some metals.

Plasma mercury levels in Hong Kong residents: in relation to fish consumption

Mercury exposure is of particular concern since mercury is a neurotoxin and the developing fetus is most sensitive to its adverse effect. Human blood is routinely used as an indicator for the evaluation of human exposure to Hg. To investigate Hg species in human plasma for Hong Kong residents and the relationship between fish consumption and Hg species in plasma, 151 plasma samples were analyzed for Hg species. The mean values of total Hg (THg) and methyl-mercury (MeHg) concentration in plasma were 0.62 and 0.28 μg/L, respectively. No significant differences were observed between females and males as well as among age groups. Fish consumption rate was significantly positively correlated with MeHg concentrations in plasma, which demonstrated that plasma could be a biomarker for human MeHg exposure. Two methods were used to estimate human MeHg exposure. One was based on fish MeHg content and fish consumption rate (EDI(Fish)), another was employed by converting MeHg concentration in blood to MeHg exposure amount (EDI(Blood)). A significant positive correlation was observed between EDI(Blood) and EDI(Fish), and no significant difference was found between EDI(Blood) and EDI(Fish). These results demonstrated that fish consumption was the major source of MeHg for humans.

Dietary predictors of maternal prenatal blood mercury levels in the ALSPAC birth cohort study

BACKGROUND

Very high levels of prenatal maternal mercury have adverse effects on the developing fetal brain. It has been suggested that all possible sources of mercury should be avoided. However, although seafood is a known source of mercury, little is known about other dietary components that contribute to the overall levels of blood mercury.

OBJECTIVE

Our goal was to quantify the contribution of components of maternal diet to prenatal blood mercury level.

METHODS

Whole blood samples and information on diet and sociodemographic factors were collected from pregnant women (n = 4,484) enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC). The blood samples were assayed for total mercury using inductively coupled plasma dynamic reaction cell mass spectrometry. Linear regression was used to estimate the relative contributions of 103 dietary variables and 6 sociodemographic characteristics to whole blood total mercury levels (TBM; untransformed and log-transformed) based on R2 values.

RESULTS

We estimated that maternal diet accounted for 19.8% of the total variation in ln-TBM, with 44% of diet-associated variability (8.75% of the total variation) associated with seafood consumption (white fish, oily fish, and shellfish). Other dietary components positively associated with TBM included wine and herbal teas, and components with significant negative associations included white bread, meat pies or pasties, and french fries.

CONCLUSIONS

Although seafood is a source of dietary mercury, seafood appeared to explain a relatively small proportion of the variation in TBM in our UK study population. Our findings require confirmation, but suggest that limiting seafood intake during pregnancy may have a limited impact on prenatal blood mercury levels.

Cadmium, lead and mercury exposure in non smoking pregnant women

Recent literature suggests that exposure to low concentrations of heavy metals may affect both maternal and child health. This study aimed to determine the biological heavy metals concentrations of pregnant women as well as environmental and dietary factors that may influence exposure concentrations. One hundred and seventy three pregnant women were recruited from Western Australia, each providing a sample of blood, first morning void urine, residential soil, dust and drinking water samples. Participants also completed a questionnaire which included a food frequency component. All biological and environmental samples were analysed for heavy metals using ICP-MS. Biological and environmental concentrations of lead and mercury were generally low (Median Pb Drinking Water (DW) 0.04 µg/L; Pb soil <3.0 µg/g; Pb dust 16.5 µg/g; Pb blood 3.67 µg/L; Pb urine 0.55; µg/L Hg DW <0.03; Hg soil <1.0 µg/g; Hg dust <1.0 µg/g; Hg blood 0.46 µg/L; Hg urine <0.40 µg/L). Cadmium concentrations were low in environmental samples (Median CdDW 0.02 µg/L; Cdsoil <0.30 ug/g; Cddust <0.30) but elevated in urine samples (Median 0.55 µg/L, creatinine corrected 0.70 µg/g (range <0.2-7.06 µg/g creatinine) compared with other studies of pregnant women. Predictors of increased biological metals concentrations in regression models for blood cadmium were residing in the Great Southern region of Western Australia and not using iron/folic acid supplements and for urinary cadmium was having lower household annual income. However, these factors explained little of the variation in respective biological metals concentrations. The importance of establishing factors that influence low human exposure concentrations is becoming critical in efforts to reduce exposures and hence the potential for adverse health effects.

Associations between socioeconomic status and environmental toxicant concentrations in adults in the USA: NHANES 2001-2010

Low level chronic exposure to toxicants is associated with a range of adverse health effects. Understanding the various factors that influence the chemical burden of an individual is of critical importance to public health strategies. We investigated the relationships between socioeconomic status (SES) and bio-monitored chemical concentration in five cross-sectional waves of the U.S. National Health and Nutrition Examination Survey (NHANES). We utilised adjusted linear regression models to investigate the association between 179 toxicants and the poverty income ratio (PIR) for five NHANES waves. We then selected a subset of chemicals associated with PIR in 3 or more NHANES waves and investigated potential mediating factors using structural equation modelling. PIR was associated with 18 chemicals in 3 or more NHANES waves. Higher SES individuals had higher burdens of serum and urinary mercury, arsenic, caesium, thallium, perfluorooctanoic acid, perfluorononanoic acid, mono(carboxyoctyl) phthalate and benzophenone-3. Inverse associations were noted between PIR and serum and urinary lead and cadmium, antimony, bisphenol A and three phthalates (mono-benzyl, mono-isobutyl, mono-n-butyl). Key mediators included fish and shellfish consumption for the PIR, mercury, arsenic, thallium and perfluorononanoic acid associations. Sunscreen use was an important mediator in the benzophenone-3/PIR relationship. The association between PIR and cadmium or lead was partially mediated by smoking, occupation and diet. These results provide a comprehensive analysis of exposure patterns as a function of socioeconomic status in US adults, providing important information to guide future public health remediation measures to decrease toxicant and disease burdens within society.

Mercury and methylmercury in Korean herbal medicines and functional health foods

Total mercury (Hg) and methyl mercury (MeHg) were analysed in functional health foods (FHFs) and in Korean herbal medicines (KHMs). A total of 560 samples (FHFs, n = 511; KHMs, n = 49) were collected. The levels of total Hg in 416 samples were lower than the limit of detection. MeHg analysis was conducted in 45 samples and the ranges of MeHg levels in samples were less than the LOD of 38.92 ng g(-1). Weekly intake per body weight (WIPBW) values of total Hg in FHFs and KHMS were 0.89 and 11.77 ng kg(-1) BW, respectively. The margins of exposure (MOEs) of total Hg for FHFs and KHMS were 598,753 and 36,503, respectively. The WIPBW values of MeHg for FHFs and KHMS were 0.22 and 0.01 ng kg(-1) BW, respectively. MOE values of MeHg for FHFs and KHMS were 412,276 and 517,363, respectively.