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Hampton JO, Pain DJ, Buenz E, Firestone SM, Arnemo JM. Lead contamination in Australian game meat. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:50713-50722. [PMID: 36797390 PMCID: PMC10104915 DOI: 10.1007/s11356-023-25949-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 02/10/2023] [Indexed: 04/16/2023]
Abstract
Lead-based ammunition (gunshot and bullets) frequently leaves small lead fragments embedded in the meat of wild-shot game animals. Australia produces several commercial game meat products from wild animals harvested with lead-based ammunition and has a growing population of recreational hunters. However, no studies have previously investigated the frequency of lead fragments or lead concentrations in Australian game meat. We examined 133 Australian minced game meat items of four types for evidence of lead contamination. Samples were meat from kangaroos (Macropus and Osphranter spp.; n=36) and Bennett's wallabies (Notamacropus rufogriseus; n=28) sold for human consumption, and deer ('venison'; multiple spp.; n=32) and stubble quail (Coturnix pectoralis; n=37) harvested for private consumption by recreational hunters. All packages were studied by digital radiography to detect the presence of radio-dense fragments, assumed to be lead fragments from ammunition. Visible fragments were absent in commercially available kangaroo products, but were present in 4%, 28% and 35% of wallaby, venison and quail, respectively. Mean meat lead concentrations (mg/kg wet weight) were 0.01 ± 0.01 for kangaroo, 0.02 ± 0.01 for wallaby, 0.12 ± 0.07 for venison, and 1.76 ± 3.76 for quail. The Australian food standards threshold for livestock meat (0.1 mg/kg w.w.) was not exceeded by any kangaroo or wallaby products but was exceeded by 53% and 86% of venison and quail, respectively. Radiography only detected 35% of samples that were above the food safety threshold. While average lead concentrations in commercially available macropod (kangaroo and wallaby) meat were low, those in recreationally harvested game meat may pose health risks for hunters and associated consumers.
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Affiliation(s)
- Jordan O Hampton
- Faculty of Science, University of Melbourne, Parkville, Victoria, 3052, Australia.
- Harry Butler Institute, Murdoch University, Murdoch, Western Australia, 6150, Australia.
| | - Deborah J Pain
- Department of Zoology, University of Cambridge, Cambridge, CB2 3QZ, UK
| | - Eric Buenz
- Nelson Marlborough Institute of Technology, Nelson, 7010, New Zealand
| | - Simon M Firestone
- Faculty of Science, University of Melbourne, Parkville, Victoria, 3052, Australia
| | - Jon M Arnemo
- Department of Forestry and Wildlife Management, Faculty of Applied Ecology and Agricultural Sciences, Inland Norway University of Applied Sciences, Koppang, Norway
- Department of Wildlife, Fish and Environmental Studies, Swedish University of Agricultural Sciences, Umeå, Sweden
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Lazarus M, Orct T, Sekovanić A, Skoko B, Petrinec B, Zgorelec Ž, Kisić I, Prevendar Crnić A, Jurasović J, Srebočan E. Spatio-temporal monitoring of mercury and other stable metal(loid)s and radionuclides in a Croatian terrestrial ecosystem around a natural gas treatment plant. ENVIRONMENTAL MONITORING AND ASSESSMENT 2022; 194:481. [PMID: 35668141 DOI: 10.1007/s10661-022-10140-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 05/27/2022] [Indexed: 06/15/2023]
Abstract
The natural gas industry bears a certain contamination risk to human and biota due to, among others, mercury, arsenic, and naturally occurring radioactive material content in gas. We tracked multiple stabile metal(loid)s and radionuclides within the natural gas treatment plant Molve, Croatia, ecosystem during the last decade through a comprehensive monitoring of soil, earthworms, moss, livestock (blood, milk, hair, urine, and feces from cows), and wildlife animals (brain, muscle, liver, and kidney of European hare and pheasant). The level of mercury and other stable metal(loid)s has shown temporal variation, but without an obvious trend. The found spatial differences in soil and earthworms were based on the differing soil characteristics of the sampled locations and exceeded the maximal allowable concentration of arsenic and zinc for agricultural soil. The status of essential copper, selenium, and zinc in cows, hares, and pheasants inclined towards deficiency. The measured stable metal(loid) levels in soil and animal samples were generally in the same range of values reported in earlier decades from the same area or non-polluted areas across Europe. The consumption of local cow and game products (e.g., milk, meat) can be considered safe for human health, although game offal is advised to be avoided as a food item due to the low risk of lead and cadmium's adverse effects. Although the activity concentrations of some radionuclides in moss were higher than reported for pristine areas, transfer from soil to moss was assessed as average (except for lead-210). Radiological risk to human and biota around the gas treatment plant Molve was estimated as negligible.
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Affiliation(s)
- Maja Lazarus
- Analytical Toxicology and Mineral Metabolism Unit, Institute for Medical Research and Occupational Health, Ksaverska c. 2, 10000, Zagreb, Croatia.
| | - Tatjana Orct
- Analytical Toxicology and Mineral Metabolism Unit, Institute for Medical Research and Occupational Health, Ksaverska c. 2, 10000, Zagreb, Croatia
| | - Ankica Sekovanić
- Radiation Protection Unit, Institute for Medical Research and Occupational Health, Ksaverska c. 2, 10000, Zagreb, Croatia
| | - Božena Skoko
- Radiation Protection Unit, Institute for Medical Research and Occupational Health, Ksaverska c. 2, 10000, Zagreb, Croatia
| | - Branko Petrinec
- Radiation Protection Unit, Institute for Medical Research and Occupational Health, Ksaverska c. 2, 10000, Zagreb, Croatia
| | - Željka Zgorelec
- Department of General Agronomy, Division of Agroecology, Faculty of Agriculture, University of Zagreb, Svetošimunska cesta 25, 10000, Zagreb, Croatia
| | - Ivica Kisić
- Department of General Agronomy, Division of Agroecology, Faculty of Agriculture, University of Zagreb, Svetošimunska cesta 25, 10000, Zagreb, Croatia
| | - Andreja Prevendar Crnić
- Department of Pharmacology and Toxicology, Faculty of Veterinary Medicine, University of Zagreb, Heinzelova 55, 10000, Zagreb, Croatia
| | - Jasna Jurasović
- Analytical Toxicology and Mineral Metabolism Unit, Institute for Medical Research and Occupational Health, Ksaverska c. 2, 10000, Zagreb, Croatia
| | - Emil Srebočan
- Department of Pharmacology and Toxicology, Faculty of Veterinary Medicine, University of Zagreb, Heinzelova 55, 10000, Zagreb, Croatia
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Simić A, Hansen AF, Syversen T, Lierhagen S, Ciesielski TM, Romundstad PR, Midthjell K, Åsvold BO, Flaten TP. Trace elements in whole blood in the general population in Trøndelag County, Norway: The HUNT3 Survey. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 806:150875. [PMID: 34634345 DOI: 10.1016/j.scitotenv.2021.150875] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 10/04/2021] [Accepted: 10/04/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Biomonitoring of a cohort within a large health survey can provide reliable information on trace element status. The main aims of this study were 1) to determine the concentrations of 28 trace elements in whole blood samples from the general population of the Nord-Trøndelag region, Norway, and 2) to investigate how trace element concentrations vary with geographical area, lifestyle, and socio-demographic factors. METHODS Whole blood samples were collected in the third survey of the Trøndelag Health Survey (HUNT3), a large population-based study in Norway. In total, 1011 whole blood samples from individuals aged 20-91 years were analyzed using high resolution inductively coupled plasma-mass spectrometry (HR-ICP-MS). We compared trace element concentrations (As, B, Be, Br, Ca, Cd, Cr, Cs, Cu, Ga, Au, In, Fe, Pb, Hg, Tl, Mg, Mn, Mo, Ni, Rb, Sc, Se, Ag, Sr, Sn, W and Zn) between three geographical areas (coastal, fjord/town, inland/mountain) using multivariable linear regression and assessed differences in trace element concentrations with socio-demographic and lifestyle factors using general linear models. RESULTS Trace element concentrations were generally comparable to levels reported in other recent studies and suggest low exposure to toxic trace elements in the region. We found geographical differences in concentrations of 19 trace elements. As, Br, Hg, and Se concentrations were higher on the coast compared to the fjord/town and inland/mountain areas, suggesting that the marine environment is an important source of exposure for these trace elements. In addition, socio-demographic and lifestyle characteristics, particularly age and sex, were associated with differences in trace element concentrations. CONCLUSIONS We report concentrations of 28 trace elements in the general population of a rural region with low exposure to pollution. Whole blood concentrations of trace elements varied with geographical area, the participants' lifestyle, and socio-demographic characteristics, highlighting the importance of considering these factors when evaluating trace element status in a population.
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Affiliation(s)
- Anica Simić
- Department of Chemistry, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Ailin Falkmo Hansen
- Department of Chemistry, NTNU, Norwegian University of Science and Technology, Trondheim, Norway; K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Tore Syversen
- Department of Neuroscience, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Syverin Lierhagen
- Department of Chemistry, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Pål Richard Romundstad
- Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kristian Midthjell
- HUNT Research Center, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Levanger, Norway
| | - Bjørn Olav Åsvold
- Department of Chemistry, NTNU, Norwegian University of Science and Technology, Trondheim, Norway; HUNT Research Center, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Levanger, Norway; Department of Endocrinology, Clinic of Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Trond Peder Flaten
- Department of Chemistry, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
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Tammone A, Caselli AE, Condorí WE, Fernandez V, Estein SM, Vanstreels RET, Sosa C, Delaloye A, Uhart MM. Lead exposure in consumers of culled invasive alien mammals in El Palmar National Park, Argentina. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:42432-42443. [PMID: 33813701 DOI: 10.1007/s11356-021-13654-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 03/22/2021] [Indexed: 06/12/2023]
Abstract
Consumption of meat from animals hunted with Pb ammunition can cause toxic accumulation with consequent health risks, even if relatively small amounts are consumed in each exposure. In El Palmar National Park, Argentina, invasive alien mammals, wild boar (Sus scrofa) and axis deer (Axis axis), are culled with Pb ammunition and their meat is consumed. In this study, we evaluated blood Pb concentrations in 58 consumers of culled game and examined Pb exposure risk according to their demographics, duty, and consumption habits. Likewise, the likelihood of exposure was evaluated by quantifying Pb concentrations in meat samples of seven culled axis deer. Twenty-seven participants (46%) had detectable blood Pb levels (limit of detection = 3.3 μg/dL), with an average 4.75 ± 1.35 μg/dL (geometric mean ± geometric S.D.); the average for all participants was 3.25 ± 1.51 μg/dL. Blood Pb concentrations were significantly higher in hunters, in participants who reported consuming game meat more than 5 times per week, and in participants who reported frequently consuming cured game meat (compared to cooked or pickled). Pb concentration varied significantly along the trajectory of the bullet in deer muscle, being highest at mid-point but with detectable Pb levels even in distant tissue samples (control), suggesting potential for dietary intake by consumers. These findings provide evidence of Pb exposure risk in consumers and emphasize the relevance of replacing Pb ammunition with non-toxic alternatives. This change would reduce dietary exposure in frequent consumers and allow the use of game meat as safe food for people whilst eliminating collateral risks to wild animals and the environment.
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Affiliation(s)
- Agostina Tammone
- Centro de Investigación Veterinaria Tandil (CONICET-CIVETAN), Universidad Nacional del Centro de la Provincia de Buenos Aires, Tandil, Buenos Aires, Argentina.
- Programa de Conservación Comunitaria del Territorio, Facultad de Ciencias Veterinarias, Universidad Nacional del Centro de la Provincia de Buenos Aires, Tandil, Buenos Aires, Argentina.
| | - Andrea Elsa Caselli
- Programa de Conservación Comunitaria del Territorio, Facultad de Ciencias Veterinarias, Universidad Nacional del Centro de la Provincia de Buenos Aires, Tandil, Buenos Aires, Argentina
| | - Walter Ezequiel Condorí
- Centro de Investigación Veterinaria Tandil (CONICET-CIVETAN), Universidad Nacional del Centro de la Provincia de Buenos Aires, Tandil, Buenos Aires, Argentina
- Programa de Conservación Comunitaria del Territorio, Facultad de Ciencias Veterinarias, Universidad Nacional del Centro de la Provincia de Buenos Aires, Tandil, Buenos Aires, Argentina
| | - Valentina Fernandez
- Programa de Conservación Comunitaria del Territorio, Facultad de Ciencias Veterinarias, Universidad Nacional del Centro de la Provincia de Buenos Aires, Tandil, Buenos Aires, Argentina
| | - Silvia Marcela Estein
- Centro de Investigación Veterinaria Tandil (CONICET-CIVETAN), Universidad Nacional del Centro de la Provincia de Buenos Aires, Tandil, Buenos Aires, Argentina
| | - Ralph Eric Thijl Vanstreels
- One Health Institute, School of Veterinary Medicine, University of California, Davis, CA, USA
- Instituto de Pesquisa e Reabilitação de Animais Marinhos (IPRAM), Cariacica, Espírito Santo, Brazil
| | - Cristian Sosa
- Parque Nacional El Palmar, Administración Nacional de Parques Nacionales Argentina, Ubajay, Entre Ríos, Argentina
| | - Aldo Delaloye
- Parque Nacional El Palmar, Administración Nacional de Parques Nacionales Argentina, Ubajay, Entre Ríos, Argentina
| | - Marcela María Uhart
- One Health Institute, School of Veterinary Medicine, University of California, Davis, CA, USA
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Perception of the Health Threats Related to the Consumption of Wild Animal Meat-Is Eating Game Risky? Foods 2021; 10:foods10071544. [PMID: 34359415 PMCID: PMC8303633 DOI: 10.3390/foods10071544] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/30/2021] [Accepted: 06/30/2021] [Indexed: 02/07/2023] Open
Abstract
Consumer interest in game meat has increased in recent years. Consumers appreciate its nutritional value but still have many concerns. Based on data from a quantitative study conducted in the group of 450 purposively selected Polish respondents declaring to consume the game meat, consumers were segmented concerning the perception of health risks associated with its consumption. Three separate clusters were identified using hierarchical cluster analysis: Indifferent (42%), Fearful (30%), and Selective (28%). The clusters differed significantly in the perception of the role of game in their lives and taking actions to mitigate the health risks associated with its consumption. In addition, their socioeconomic profiles were significantly different. The Indifferent segment-significantly more often than the other segments-believes that game has a positive impact on health, and the way to counteract the health risks is to not eat raw meat. The Selective segment attaches great importance to the choice of consumption place as a warranty of access to safe meat. The Fearful segment is willing to pay more for good quality meat and search for information. The results proved that the game consumers are not a homogenous group. Recognizing the differences can indicate a path for the traders to efficiently meet the consumers' expectations and needs.
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Almerud P, Zamaratskaia G, Lindroos AK, Bjermo H, Andersson EM, Lundh T, Ankarberg EH, Lignell S. Cadmium, total mercury, and lead in blood and associations with diet, sociodemographic factors, and smoking in Swedish adolescents. ENVIRONMENTAL RESEARCH 2021; 197:110991. [PMID: 33705767 DOI: 10.1016/j.envres.2021.110991] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 02/10/2021] [Accepted: 03/03/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Despite their vulnerability to the toxic effects of certain metals, biomonitoring data on adolescents are limited. In the present study, we assessed blood concentrations of toxic metals (cadmium [Cd], total mercury [Hg], and lead [Pb] in a national representative sample of Swedish adolescents. We also examined the associations of Cd, total Hg and Pb with habitual intakes of major energy-providing food groups and other possible determinants such as age, sex, household education, Nordic or non-Nordic origin, and smoking. METHODS We analysed blood concentrations of Cd, total Hg, and Pb in a sample of 1099 adolescents from the Riksmaten Adolescents 2016-17 study in three age groups (mean age of 12, 15, and 18 years) using inductively coupled plasma mass spectrometry. The participants completed web-based questionnaires on food consumption frequency, sociodemographic factors and health status. Dietary data from two web-based 24-h dietary recalls were used to estimate the habitual intake of 10 major food groups. RESULTS Almost all participants had detectable concentrations of Cd, total Hg, and Pb in whole blood. The median blood concentrations were 0.12 μg/L for Cd, 0.72 μg/L for total Hg, and 7.1 μg/L for Pb. Higher blood concentrations of Cd were observed in girls than in boys, whereas concentrations of total Hg and Pb were higher in boys. We observed an inverse association between Cd and meat intake. Total Hg concentrations were positively associated with intakes of fish, eggs, meat, and vegetables, and Pb concentrations were inversely associated with intakes of dairy products. Furthermore, smokers had higher concentrations of Cd and Pb. CONCLUSIONS We found that fish was a potentially important source of exposure to total Hg in Swedish adolescents. No other food group was identified to have a strong impact on the blood levels of Cd, total Hg and Pb. Thirteen per cent of the adolescents had blood Pb concentrations above 12 μg/L, the reference point used in the risk assessment of Pb by the European Food Safety Authority (EFSA).
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Affiliation(s)
- Pernilla Almerud
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden; Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Galia Zamaratskaia
- Department of Risk and Benefit Assessment, Swedish Food Agency, Uppsala, Sweden
| | - Anna Karin Lindroos
- Department of Risk and Benefit Assessment, Swedish Food Agency, Uppsala, Sweden; Department of Internal Medicine and Clinical Nutrition, The Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Helena Bjermo
- Department of Risk and Benefit Assessment, Swedish Food Agency, Uppsala, Sweden
| | - Eva M Andersson
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden; Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Thomas Lundh
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | | | - Sanna Lignell
- Department of Risk and Benefit Assessment, Swedish Food Agency, Uppsala, Sweden.
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Sevillano-Morales JS, Sevillano-Caño J, Cámara-Martos F, Moreno-Ortega A, Amaro-López MA, Arenas-Casas A, Moreno-Rojas R. Risk Assessment of Cd, Cu, and Pb from the consumption of hunted meat: red-legged partridge and wild rabbit. Biol Trace Elem Res 2021; 199:1843-1854. [PMID: 32734532 DOI: 10.1007/s12011-020-02290-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 07/14/2020] [Indexed: 10/23/2022]
Abstract
The objective was to assess that potential health risk from Cd, Cu, and Pb, through the consumption of hunted red-legged partridge and wild rabbit meat, with special focus on the population of hunters and their relatives. Mineral content was analyzed by atomic absorption methods (F-AAS for Cu and GF-AAS for Cd and Pb) after microwave digestion of lyophilized samples. The average concentrations of these elements were 0.008 and 0.01 mg/kg for Cd; 1.41 and 1.63 mg/kg for Cu and 0.98 and 1.28 mg/kg for Pb in wild rabbit and red-legged partridge meat respectively. The dietary, risk assessment was performed by assuming two intake scenarios based on the obtained results of the survey on game meat consumption and the current maximum recommended intakes of Cd, Cu, and Pb, and then, the hazard quotients (THQ and TTHQ) were calculated. The data show that exposure to these metals from eating red-legged partridge and wild rabbit meat from a hunting provenance is relatively low and generally greater in the hunter population. The risk assessment revealed that moderate or low consumption of meat of these species does not offer a significant public health risk. Moreover, hazard quotients values for these metals of red-legged partridge and rabbit meat consumption in hunters and nonhunters are below 1. However, a high Pb content in the meat of these species and a high consumption may pose a greater health risk to hunters.
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Affiliation(s)
- Jesús Salvador Sevillano-Morales
- Departamento de Bromatología y Tecnología de los Alimentos, Universidad de Córdoba, Campus Universitario de Rabanales, Edificio Charles Darwin C-1, 14014, Córdoba, Spain
| | - Jesús Sevillano-Caño
- Departamento de Bromatología y Tecnología de los Alimentos, Universidad de Córdoba, Campus Universitario de Rabanales, Edificio Charles Darwin C-1, 14014, Córdoba, Spain
| | - Fernando Cámara-Martos
- Departamento de Bromatología y Tecnología de los Alimentos, Universidad de Córdoba, Campus Universitario de Rabanales, Edificio Charles Darwin C-1, 14014, Córdoba, Spain.
| | - Alicia Moreno-Ortega
- Departamento de Bromatología y Tecnología de los Alimentos, Universidad de Córdoba, Campus Universitario de Rabanales, Edificio Charles Darwin C-1, 14014, Córdoba, Spain
| | - Manuel Angel Amaro-López
- Departamento de Bromatología y Tecnología de los Alimentos, Universidad de Córdoba, Campus Universitario de Rabanales, Edificio Charles Darwin C-1, 14014, Córdoba, Spain
| | - Antonio Arenas-Casas
- Departamento de Bromatología y Tecnología de los Alimentos, Universidad de Córdoba, Campus Universitario de Rabanales, Edificio Charles Darwin C-1, 14014, Córdoba, Spain
| | - Rafael Moreno-Rojas
- Departamento de Bromatología y Tecnología de los Alimentos, Universidad de Córdoba, Campus Universitario de Rabanales, Edificio Charles Darwin C-1, 14014, Córdoba, Spain
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Marination increases the bioavailability of lead in game meat shot with lead ammunition. J Nutr Sci 2021; 10:e24. [PMID: 33996037 PMCID: PMC8080222 DOI: 10.1017/jns.2021.15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/01/2021] [Accepted: 03/05/2021] [Indexed: 11/24/2022] Open
Abstract
As a consequence of the toxicological lead characteristics, a reduction of its exposure should consider all sources. Game meat might contain elevated levels of lead due to the use of lead ammunition. The aim of the present study was to investigate the effects of acidic marination on the bioavailability of ammunition-derived lead in game meat (Roe deer), using the growing pig as an animal model. Furthermore, the study should provide evidence that the large-area scattering of lead particles leads to noticeable differences in the individual lead intake per game meat portion. Pigs of group A (n 7) received lead-shot game meat, which was cooked in water. Pigs of group B (n 7) received lead-shot game meat, which was first marinated (wine and vinegar) and then cooked. The lead content of both game meat preparations was equal with 0⋅77–0⋅79 mg Pb/portion. Pigs of group C (n 4) received lead-free game meat, which was also marinated and cooked. Additionally, lead acetate was administered intravenously to group D pigs (n 4). Blood samples were taken on elevated time points before and after game meat intake/i.v.-application. The acidic marination increased the bioavailability of orally ingested lead, resulting in significantly higher blood lead concentrations. The bioavailability of lead was 2⋅7 % when game meat was just cooked and 15 % when the meat was marinated before. The considerable variation of the individual blood lead concentrations suggests that an inhomogeneous distribution of ammunition-derived lead particles (in terms of size and number) causes individually non-comparable lead intakes from the consumption of game meat.
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Schulz JH, Wilhelm Stanis SA, Hall DM, Webb EB. Until It's a regulation It's not my fight: Complexities of a voluntary nonlead hunting ammunition program. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2021; 277:111438. [PMID: 33027735 DOI: 10.1016/j.jenvman.2020.111438] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 09/16/2020] [Accepted: 09/20/2020] [Indexed: 06/11/2023]
Abstract
Wildlife and human health are at risk of lead exposure from spent hunting ammunition. Lead exposure persists for bald eagles due to bullet fragments in game animal gut piles and unretrieved carcasses, and is also a human health risk when wild game is procured using lead ammunition. Programs encouraging the voluntary use of nonlead ammunition have become a popular approach mitigating these effects. This study explored attitudes and experiences of United States Fish and Wildlife Service (USFWS) staff implementing an outreach program encouraging deer hunters to voluntary use nonlead ammunition on 54 National Wildlife Refuges (NWRs) in the Upper Midwest, U.S. to understand factors affecting program implementation. We conducted 29 semi-structured interviews of USFWS staff along with 60 responses from an open-ended survey question. Twelve themes emerged from the data and were grouped into three broad categories: (1) challenges of dealing with complex issues, (2) importance of messengers and messages, and (3) resistance from staff. Challenges of dealing with complex issues included administrative restraint and uncertainty, scope and scale of program, human health not an agency responsibility, contextual political influences, and public-private collaborations. Importance of messengers and messages included the importance of experience, and salience of human health risk. Finally, resistance from staff included skepticism of the science and motives behind the program, competing priorities for refuge staff, differing perceptions of regulatory and voluntary approaches, cost and availability of nonlead ammunition, and disregard by some about lead ammunition and human health risks. Staff identified numerous challenges implementing the program, many of which were external factors beyond the control of the participants. Understanding the factors affecting program implementation may help guide future efforts encouraging the voluntary use of nonlead ammunition.
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Affiliation(s)
- John H Schulz
- School of Natural Resources, University of Missouri, 105 Anheuser-Busch Natural Resources Building, Columbia, MO, 65211, USA.
| | - Sonja A Wilhelm Stanis
- School of Natural Resources, University of Missouri, 105 Anheuser-Busch Natural Resources Building, Columbia, MO, 65211, USA.
| | - Damon M Hall
- School of Natural Resources, University of Missouri, 105 Anheuser-Busch Natural Resources Building, Columbia, MO, 65211, USA; Biomedical, Biological and Chemical Engineering, University of Missouri, 215 Agriculture Engineering Building, Columbia, MO, 65211, USA.
| | - Elisabeth B Webb
- U.S. Geological Survey, Missouri Cooperative Fish and Wildlife Research Unit, 302 Anheuser-Busch Natural Resources Building, Columbia, MO, 65211, USA.
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Tsuji LJS, Tsuji SRJ, Zuk AM, Davey R, Liberda EN. Harvest Programs in First Nations of Subarctic Canada: The Benefits Go Beyond Addressing Food Security and Environmental Sustainability Issues. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8113. [PMID: 33153153 PMCID: PMC7663715 DOI: 10.3390/ijerph17218113] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 10/26/2020] [Accepted: 10/30/2020] [Indexed: 12/04/2022]
Abstract
By breaking down barriers that impacted the ability of subarctic First Nations people to harvest waterfowl, the Sharing-the-Harvest program provided a safe, nutritious, and culturally appropriate food (i.e., geese) to James Bay Cree communities while also helping to protect the environment by harvesting overabundant geese. However, the impacts extend beyond those described above. Thus, the objectives of the present paper are twofold: to document the food sharing networks of the Sharing-the-Harvest program; and to examine the benefits associated with the harvest program beyond food security and environmental sustainability issues, as revealed through semi-directed interviews. In the regional initiative, harvested geese were shared with all James Bay communities; sharing is an important part of Cree culture. Where detailed information was collected, the goose-sharing network reached 76% of the homes in one of the communities. Likewise, in the local initiative, the goose-sharing network had a 76% coverage rate of the homes in the community. Although decreasing food insecurity was an important focus of the harvest-sharing programs, there were other benefits, from an Indigenous perspective, of being on the land, as identified by the Cree harvesters through semi-directed interviews (e.g., the transmission of Indigenous knowledge, the strengthening of social networks, and the feeling of wellness while out on-the-land). Thus, by participating in the on-the-land harvest programs, the Cree gained benefits beyond those solely related to strengthening food security and contributing in part to environmental sustainability. The Sharing-the-Harvest protocol has the potential to be adapted and employed by other Indigenous (or marginalized) groups worldwide, to help improve health and wellness, while, also protecting the environment from overabundant and/or invasive species.
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Affiliation(s)
- Leonard J. S. Tsuji
- Department of Physical and Environmental Sciences, University of Toronto, Toronto, ON M1C 1A4, Canada;
| | - Stephen R. J. Tsuji
- School of Environmental Studies, Queen’s University, Kingston, ON K7L 3N6, Canada;
| | - Aleksandra M. Zuk
- Department of Physical and Environmental Sciences, University of Toronto, Toronto, ON M1C 1A4, Canada;
- School of Nursing, Faculty of Health Sciences, Queen’s University, Kingston, ON K7L 3N6, Canada
| | - Roger Davey
- Fort Albany First Nation, Fort Albany, ON P0L 1H0, Canada;
| | - Eric N. Liberda
- School of Occupational and Public Health, Ryerson University, Toronto, ON M5B 2K3, Canada;
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Niewiadomska K, Kosicka-Gębska M, Gębski J, Gutkowska K, Jeżewska-Zychowicz M, Sułek M. Game Meat Consumption-Conscious Choice or Just a Game? Foods 2020; 9:foods9101357. [PMID: 32987949 PMCID: PMC7601238 DOI: 10.3390/foods9101357] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 09/18/2020] [Accepted: 09/20/2020] [Indexed: 12/19/2022] Open
Abstract
Game meat is constantly present on the European meat market, but a limited number of consumers are interested in its consumption. Considering the unique features of wild animal meat, we should explore what pushes consumers to include it in their diet. To identify the motives determining the choice of game meat, a quantitative survey based on the computer-assisted telephone interview (CATI) method was conducted among 450 participants. The statistical analysis based on the logistic regression model allowed us to assess the significance of emotional motives leading to game eating and to investigate the importance of the rational motives related to the quality attributes of game for consumers. It was shown that rational motives influence the consumers’ choice more than emotional factors, while the most important motives are connected with healthcare issues. Consumers, for whom the crucial attributes of quality are taste, nutritional value, and low fat content, constitute a group that might more often include game in their diet in the future. Among the emotional motives, the familiarity, described as a feeling of knowing the product, also has a statistically significant impact on the consumers’ choice. The results obtained may be useful for academic theoreticians and market experts as well.
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12
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Broadway MS, McCallen EB, Caudell J, Stewart CM. Ammunition Type and Shot Placement Determine Lead Fragmentation in Deer. J Wildl Manage 2020. [DOI: 10.1002/jwmg.21917] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Matthew S. Broadway
- Indiana Division of Fish and WildlifeWildlife Science 5596 E. State Road 46 Bloomington IN 47401 USA
| | - Emily B. McCallen
- Indiana Division of Fish and WildlifeWildlife Science 5596 E. State Road 46 Bloomington IN 47401 USA
| | - Joe Caudell
- Indiana Division of Fish and WildlifeWildlife Science 5596 E. State Road 46 Bloomington IN 47401 USA
| | - Chad M. Stewart
- Michigan Department of Natural Resources 4166 Legacy Parkway Lansing MI 48911 USA
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Green RE, Pain DJ. Risks to human health from ammunition-derived lead in Europe. AMBIO 2019; 48:954-968. [PMID: 31098877 PMCID: PMC6675757 DOI: 10.1007/s13280-019-01194-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 04/17/2019] [Accepted: 04/19/2019] [Indexed: 05/22/2023]
Abstract
It has been known for centuries that lead is toxic to humans. Chronic exposure to lead, even at low levels, is associated with an elevated risk of cardiovascular and chronic kidney disease in adults and of impaired neurodevelopment and subsequent cognitive and behavioural development in the foetus and young children. Health agencies throughout the world have moved from assuming that there are tolerable levels of exposure to lead to a recognition that valid 'no-effect' thresholds cannot currently be defined. Formerly, the most important exposure pathways were occupational exposure, water from lead plumbing, paints, petrol additives and foods. Regulation of products and improved health and safety procedures at work have left dietary lead as the main remaining pathway of exposure in European countries. Ammunition-derived lead is now a significant cause of dietary lead exposure in groups of people who eat wild game meat frequently. These are mostly hunters, shoot employees and their families, but also some people who choose to eat game for ethical, health or other reasons, and their children. Extrapolation from surveys conducted in the UK and a review of studies of game consumption in other countries suggest that approximately 5 million people in the EU may be high-level consumers of lead-shot game meat and that tens of thousands of children in the EU may be consuming game contaminated with ammunition-derived lead frequently enough to cause significant effects on their cognitive development.
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Affiliation(s)
- Rhys E. Green
- Department of Zoology, University of Cambridge, David Attenborough Building, Pembroke Street, Cambridge, CB2 3QZ UK
| | - Deborah J. Pain
- Department of Zoology, University of Cambridge, David Attenborough Building, Pembroke Street, Cambridge, CB2 3QZ UK
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14
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Vollset M, Iszatt N, Enger Ø, Gjengedal ELF, Eggesbø M. Concentration of mercury, cadmium, and lead in breast milk from Norwegian mothers: Association with dietary habits, amalgam and other factors. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 677:466-473. [PMID: 31063889 DOI: 10.1016/j.scitotenv.2019.04.252] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 04/12/2019] [Accepted: 04/16/2019] [Indexed: 06/09/2023]
Abstract
Mercury (Hg), cadmium (Cd), and lead (Pb) are of great concern for food safety and infants are especially sensitive to exposure to the maternal body burden. We quantified these elements in breast milk from Norwegian mothers and determined their association with dietary habits, maternal amalgam fillings, and smoking. Breast milk (n = 300) from the Norwegian Human Milk Study (HUMIS) was analyzed using triple quadrupole inductively coupled plasma mass spectrometry, after an acidic decomposition using microwave technique. We used multiple linear regression to examine predictors of Hg and Cd in breast milk, and logistic regression to test predictors of Pb above the quantification limit. The median breast milk concentrations (minimum - maximum) were 0.20 μg Hg/kg (<0.058-0.89), 0.057 μg Cd/kg (0.017-1.2), and <0.67 μg Pb/kg (<0.2-7.5). Cadmium showed no significant relation with any exposure variable investigated. Lead was associated with intake of liver and kidneys from game. For Hg concentration in breast milk, number of amalgam fillings and high fish consumption were significant predictors (p < 0.001). We detected a significant association (p < 0.01) between Hg in breast milk and maternal consumption of Atlantic halibut, lean fish, mussels and scallops and lifetime consumption of crab. Seafood intake alone explained 10% of variance, while together with amalgam explained 46% of variance in Hg concentration in breast milk. Our findings emphasize the importance of following consumer advice with respect to fish and seafood and points to amalgam as an important source for Hg exposure.
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Affiliation(s)
- Marie Vollset
- Faculty of Environmental Sciences and Natural Resource Management, Norwegian University of Life Sciences, P.O. Box 5003, NO-1432 Aas, Norway.
| | - Nina Iszatt
- Department of Environmental Exposure and Epidemiology, Norwegian Institute of Public Health, P.O. Box 4404, N-0403 Oslo, Norway.
| | - Øyvind Enger
- Faculty of Environmental Sciences and Natural Resource Management, Norwegian University of Life Sciences, P.O. Box 5003, NO-1432 Aas, Norway
| | - Elin Lovise Folven Gjengedal
- Faculty of Environmental Sciences and Natural Resource Management, Norwegian University of Life Sciences, P.O. Box 5003, NO-1432 Aas, Norway.
| | - Merete Eggesbø
- Department of Environmental Exposure and Epidemiology, Norwegian Institute of Public Health, P.O. Box 4404, N-0403 Oslo, Norway.
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Martin A, Müller-Graf C, Selhorst T, Gerofke A, Ulbig E, Gremse C, Greiner M, Lahrssen-Wiederholt M, Hensel A. Comparison of lead levels in edible parts of red deer hunted with lead or non-lead ammunition. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 653:315-326. [PMID: 30412876 DOI: 10.1016/j.scitotenv.2018.10.393] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 10/26/2018] [Accepted: 10/28/2018] [Indexed: 06/08/2023]
Abstract
Game meat may contain elevated concentrations of lead especially if lead-containing ammunition is used for hunting. Then a health risk is possible for consumer groups with high game meat intake. The lead concentrations in three edible parts (marketable meat from the area close to the wound channel, saddle and haunch) of meat from red deer (Cervus elaphus) between animals hunted either with lead or non‑lead ammunition were compared. Furthermore, lead levels in game meat of lead-shot red deer were compared with those of lead-shot roe deer and lead-shot wild boar. Ninety red deer were shot and killed in the context of this study (64 with lead and 26 with non‑lead ammunition). Since the lead concentration for a number of the samples was below the limit of detection or the limit of quantification, statistical methods for left-censored data were applied. The median concentrations of lead in game meat did not differ significantly between lead shot and non‑lead shot animals. However, when we analyzed the more elevated lead concentrations, they were significantly higher in edible parts of animals shot with lead ammunition than non-lead ammunition. The highest concentrations were found in samples from edible meat from the area close to the wound channel (max 3442 mg Pb/kg), followed by the saddle (max 1.14 mg Pb/kg) and with the lowest levels in the haunch (max 0.09 mg Pb/kg). A comparison of game species revealed that the lead concentration in haunch and saddle of lead shot red deer was higher than in the corresponding samples of lead shot roe deer. Our results have shown that by the use of non-lead ammunition, a significant reduction of the lead concentration especially in edible parts near the wound channel is possible.
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Affiliation(s)
- Annett Martin
- German Federal Institute for Risk Assessment (BfR), Unit of Epidemiology, Statistics and Mathematical Modelling, Department Exposition, Max-Dohrn-Straße 8-10, 10589 Berlin, Germany; German Federal Institute for Risk Assessment (BfR), Berlin, Department Exposure, Max-Dohrn-Straße 8-10, 10589 Berlin, Germany.
| | - Christine Müller-Graf
- German Federal Institute for Risk Assessment (BfR), Berlin, Department Exposure, Max-Dohrn-Straße 8-10, 10589 Berlin, Germany
| | - Thomas Selhorst
- German Federal Institute for Risk Assessment (BfR), Berlin, Department Exposure, Max-Dohrn-Straße 8-10, 10589 Berlin, Germany
| | - Antje Gerofke
- German Federal Institute for Risk Assessment (BfR), Berlin, Department Safety in the Food Chain, Max-Dohrn-Straße 8-10, 10589 Berlin, Germany
| | - Ellen Ulbig
- German Federal Institute for Risk Assessment (BfR), Berlin, Department Safety in the Food Chain, Max-Dohrn-Straße 8-10, 10589 Berlin, Germany
| | - Carl Gremse
- German Federal Institute for Risk Assessment (BfR), Berlin, Department Safety in the Food Chain, Max-Dohrn-Straße 8-10, 10589 Berlin, Germany
| | - Matthias Greiner
- German Federal Institute for Risk Assessment (BfR), Berlin, Department Exposure, Max-Dohrn-Straße 8-10, 10589 Berlin, Germany
| | - Monika Lahrssen-Wiederholt
- German Federal Institute for Risk Assessment (BfR), Berlin, Department Safety in the Food Chain, Max-Dohrn-Straße 8-10, 10589 Berlin, Germany
| | - Andreas Hensel
- German Federal Institute for Risk Assessment (BfR), Berlin, Max-Dohrn-Straße 8-10, 10589 Berlin, Germany
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16
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Sevillano Morales J, Moreno-Ortega A, Amaro Lopez MA, Arenas Casas A, Cámara-Martos F, Moreno-Rojas R. Game meat consumption by hunters and their relatives: a probabilistic approach. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2018; 35:1739-1748. [PMID: 29912678 DOI: 10.1080/19440049.2018.1488183] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
This study aimed to estimate the consumption of meat and products derived from hunting by the consumer population and, specifically, by hunters and their relatives. For this purpose, a survey was conducted on the frequency of consuming meat from the four most representative game species in Spain, two of big game, wild boar (Sus scrofa) and red deer (Cervus elaphus), and two of small game, rabbit (Oryctolagus cuniculus) and red partridge (Alectoris rufa), as well as of processed meat products (salami-type sausage) made from those big game species. The survey was carried out on 337 habitual consumers of these types of products (hunters and their relatives). The total mean game meat consumption, per capita in this population group, is 6.87 kg/person/year of meat and 8.57 kg/person/year if the processed meat products are also considered. Consumption of rabbit, red partridge, red deer and wild boar, individually, was 1.85, 0.82, 2.28 and 1.92 kg/person/year, respectively. It was observed that hunters generally registered a larger intake of game meat, this being statistically significant in the case of rabbit meat consumption. Using probabilistic methods, the meat consumption frequency distributions for each hunting species studied were estimated, as well as the products made from big game species and the total consumption both of meat by itself and that including the products made from it. The consumption frequency distributions were adjusted to exponential ones, verified by the test suitable for it according to Akaike Information Criterion (AIC), Bayesian Information Criterion (BIC), the Chi-squared and Kolmogorov-Smirnov statistics. In addition, the consumption percentiles of the different distributions were obtained. The latter could be a good tool when making nutrition or contaminant studies since they permit the assessment of exposure to the compound in question.
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Affiliation(s)
- Jesus Sevillano Morales
- a Departments of Bromatology and Food Technology and Animal Health of the Faculty of Veterinary Medicine , University of Córdoba , Córdoba , Spain
| | - Alicia Moreno-Ortega
- a Departments of Bromatology and Food Technology and Animal Health of the Faculty of Veterinary Medicine , University of Córdoba , Córdoba , Spain
| | - Manual Angel Amaro Lopez
- a Departments of Bromatology and Food Technology and Animal Health of the Faculty of Veterinary Medicine , University of Córdoba , Córdoba , Spain
| | - Antonio Arenas Casas
- a Departments of Bromatology and Food Technology and Animal Health of the Faculty of Veterinary Medicine , University of Córdoba , Córdoba , Spain
| | - Fernando Cámara-Martos
- a Departments of Bromatology and Food Technology and Animal Health of the Faculty of Veterinary Medicine , University of Córdoba , Córdoba , Spain
| | - Rafael Moreno-Rojas
- a Departments of Bromatology and Food Technology and Animal Health of the Faculty of Veterinary Medicine , University of Córdoba , Córdoba , Spain
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Buenz EJ, Parry GJ. Chronic Lead Intoxication From Eating Wild-Harvested Game. Am J Med 2018; 131:e181-e184. [PMID: 29247605 DOI: 10.1016/j.amjmed.2017.11.031] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Accepted: 11/13/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND The purpose of this article is to determine if conversion from eating wild game harvested with lead-based ammunition to nonlead-based ammunition results in lower blood lead levels. Supersonic injection of toxin-leeching frangible projectiles into food is intuitively bad. As much as 95% of the ~13.7 million hunters in the United States choose shrapnel-inducing lead bullets to kill game; in addition, not harvesting meat is an incarcerable crime. A lead ammunition ban on certain federal lands was recently rescinded and the National Rifle Association refutes any risk from eating lead bullet-harvested game. METHODS A patient subsisting solely on lead-shot meat was converted to non-lead ammunition and his blood lead level tracked. Concomitant with his conversion to nonlead ammunition, a controlled experiment was performed using the patient's bullets to determine his daily lead intake from lead-shot meat. RESULTS While eating lead-shot meat, the patient was consuming 259.3 ± 235.6 µg of lead daily and his blood lead level was 74.7 µg/dL. Conversion to nonlead ammunition was associated with a reduced blood lead level. CONCLUSIONS Unsafe blood lead levels can occur from eating game harvested with lead ammunition. Physicians should warn hunting patients of this potential risk and counsel them about the availability of nonlead ammunition alternatives.
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Affiliation(s)
- Eric J Buenz
- Nelson Marlborough Institute of Technology, Nelson, New Zealand.
| | - Gareth J Parry
- Nelson Marlborough Institute of Technology, Nelson, New Zealand
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Juric AK, Batal M, David W, Sharp D, Schwartz H, Ing A, Fediuk K, Black A, Tikhonov C, Chan HM, Chan L. Risk assessment of dietary lead exposure among First Nations people living on-reserve in Ontario, Canada using a total diet study and a probabilistic approach. JOURNAL OF HAZARDOUS MATERIALS 2018; 344:55-63. [PMID: 29031094 DOI: 10.1016/j.jhazmat.2017.09.035] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 09/19/2017] [Accepted: 09/21/2017] [Indexed: 06/07/2023]
Abstract
Indigenous peoples have elevated risk of lead (Pb) exposure as hunted traditional food can be contaminated with lead-containing ammunition. Recent scientific consensus states that there is no threshold level for Pb exposure. The objective of this study was to estimate dietary exposure to Pb among First Nations living on-reserve in the province of Ontario, Canada. A total diet study was constructed based on a 24-h recall and Pb concentrations for traditional foods from the First Nations Food, Nutrition, and Environment Study (FNFNES) and Pb concentrations in market foods from Health Canada. A probabilistic assessment of annual and seasonal traditional food consumption was conducted. Results indicate that traditional foods, particularly moose and deer meat. are the primary source of dietary Pb intake (73%), despite providing only 1.8% of the average caloric intake. The average dietary Pb exposure (0.21μg/kg/d) in the First Nations population in Ontario was 1.7 times higher than the dietary Pb exposure in the general Canadian population. Pb intake was associated with an estimated average increase in systolic blood pressure of 1.2mmHg. These results indicate that consumption of foods hunted with Pb containing ammunition and shot puts the population at elevated risk of Pb toxicity.
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Affiliation(s)
| | | | - Will David
- Assembly of First Nations, Ottawa, Canada
| | | | - Harold Schwartz
- Health Canada, Environmental Public Health Division, First Nations and Inuit Health Branch (FNIHB), Ottawa, Canada
| | - Amy Ing
- Université de Montréal, Montreal, Canada
| | - Karen Fediuk
- Dietitian and Nutrition Researcher, British Columbia, Canada
| | | | - Constantine Tikhonov
- Health Canada, Environmental Public Health Division, First Nations and Inuit Health Branch (FNIHB), Ottawa, Canada
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Hampton JO, Laidlaw M, Buenz E, Arnemo JM. Heads in the sand: public health and ecological risks of lead-based bullets for wildlife shooting in Australia. WILDLIFE RESEARCH 2018. [DOI: 10.1071/wr17180] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Lead (Pb) is a toxic element banned from fuel, paint and many other products in most developed countries. Nonetheless, it is still widely used in ammunition, including rifle bullets, and Pb-based bullets are almost universally used in Australia. For decades, poisoning from Pb shot (shotguns) has been recognised as a cause of disease in waterfowl and Pb shot has been subsequently banned for waterfowl hunting in many jurisdictions. However, the risks posed by Pb-based bullets (rifles) have not been similarly recognised in Australia. Pb-based rifle bullets frequently fragment, contaminating the tissue of shot animals. Consuming this Pb-contaminated tissue risks harmful Pb exposure and, thus, the health of wildlife scavengers (carrion eaters) and humans and their companion animals who consume harvested meat (game eaters). In Europe, North America and elsewhere, the environmental and human health risks of Pb-based bullets are widely recognised, and non-toxic alternatives (e.g. copper-based bullets) are increasingly being used. However, Australia has no comparable research despite widespread use of shooting, common scavenging by potentially susceptible wildlife species, and people regularly consuming shot meat. We conclude that Australia has its collective ‘head in the sand’ on this pressing worldwide One Health issue. We present the need for urgent research into this field in Australia.
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Wennberg M, Lundh T, Sommar JN, Bergdahl IA. Time trends and exposure determinants of lead and cadmium in the adult population of northern Sweden 1990-2014. ENVIRONMENTAL RESEARCH 2017; 159:111-117. [PMID: 28787621 DOI: 10.1016/j.envres.2017.07.029] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 07/12/2017] [Accepted: 07/13/2017] [Indexed: 06/07/2023]
Abstract
INTRODUCTION This study follows cadmium and lead concentrations in blood in the adult population in northern Sweden over 24 years. MATERIAL AND METHODS Concentrations of lead and cadmium were measured in single whole blood samples (B-Pb and B-Cd) from 619 men and 926 women participating in the Northern Sweden WHO MONICA Study on one occasion 1990-2014. Associations with smoking and dietary factors were investigated. Consumption of moose meat was asked for in 2014. RESULTS In the adult population in northern Sweden, the median B-Pb in 2014 was 11.0µg/L in young (25-35 years) men and 9.69µg/L in young women. In an older age-group (50-60 years), the median B-Pb was 15.1µg/L in men and 13.1µg/L in women. B-Pb decreased from 1990 to 2009, after which time no further decrease was observed. B-Pb was higher in smokers than in non-smokers. In never-smokers, positive associations were found between B-Pb and consumption of wine and brewed coffee (women only) in 2004-2014. Higher B-Pb with consumption of moose meat was demonstrated in men, but not in women. B-Cd was essentially stable over the whole period, but an increase in B-Cd, of 3% per year, was detected in never-smoking women between 2009 and 2014. In 2014, median B-Cd in never-smokers in the four groups was; 0.11µg/L in younger men, 0.15µg/L in younger women, 0.14µg/L in older men, and 0.21µg/L in older women. B-Cd was higher in smokers than in non-smokers. The only positive association between B-Cd and food items in 2004-2014 was with consumption of brewed coffee (men only). CONCLUSIONS The lack of a decrease in B-Cd from 1990 to 2014 and the absence of a further decrease in B-Pb after 2009 are unsatisfactory considering the health risks these metals pose in the general population at current concentrations.
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Affiliation(s)
- Maria Wennberg
- Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University, Umeå, Sweden.
| | - Thomas Lundh
- Department of Occupational and Environmental Medicine, Lund University, Lund, Sweden.
| | - Johan Nilsson Sommar
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden.
| | - Ingvar A Bergdahl
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden; Department of Biobank Research, Umeå University, Umeå, Sweden.
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Fustinoni S, Sucato S, Consonni D, Mannucci PM, Moretto A. Blood lead levels following consumption of game meat in Italy. ENVIRONMENTAL RESEARCH 2017; 155:36-41. [PMID: 28189071 DOI: 10.1016/j.envres.2017.01.041] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 01/24/2017] [Accepted: 01/26/2017] [Indexed: 06/06/2023]
Abstract
The aim of this study was to measure lead (Pb) levels in blood (Pb-blood) in consumers of game meat, taking into account other possible sources of lead exposure. A spot blood sample was obtained from 95 subjects, and a questionnaire was used to collect general information and data on game meat consumption, hunting, wine drinking and other possible sources of lead exposure. Pb-blood was measured by inductively coupled plasma-mass spectrometry. Pb-blood was not influenced by age, sex, residence in an urban or rural area, consumption of game meat, tobacco smoking or hobbies associated with potential exposure to lead, and median Pb-blood was 1.7 (5th-95th percentile 1.0-5.3)µg/dL and 3.4 (0.9-6.1)µg/dL for game meat non-eaters and eater, respectively. A multiple linear regression analysis (containing the covariates sex, age, hunting, wine drinking, game meat consumption, tobacco smoking, shooting range, and occupational exposure) found an association with hunting (Pb-blood almost double in hunters) and wine drinking (40% higher in drinkers) but not with consumption of game meat or other parameters. Whether the higher Pb-blood level was due to inhalation of lead fumes while shooting with lead ammunition, to handling lead ammunition or both could not be ascertained.
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Affiliation(s)
- Silvia Fustinoni
- Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano, Via S. Barnaba 8, 20122 Milan, Italy; Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via S. Barnaba 8, 20122 Milan, Italy.
| | - Sabrina Sucato
- Dipartimento di Scienze Cliniche e di Comunità, Università degli Studi di Milano, Via S. Barnaba 8, 20122 Milan, Italy.
| | - Dario Consonni
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via S. Barnaba 8, 20122 Milan, Italy.
| | - Pier Mannuccio Mannucci
- Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico and Università degli Studi di Milano, Via Francesco Sforza 35, 20122 Milan, Italy.
| | - Angelo Moretto
- Dipartimento di Scienze Biomediche e Cliniche, Università degli Studi di Milano, and International Centre for Pesticides and Health Risks Protection (ICPS), ASST-Fatebenefratelli, "Luigi Sacco" Hospital, Via GB Grassi 74, 20157 Milan, Italy.
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Giżejewska A, Szkoda J, Nawrocka A, Żmudzki J, Giżejewski Z. Can red deer antlers be used as an indicator of environmental and edible tissues' trace element contamination? ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2017; 24:11630-11638. [PMID: 28324255 PMCID: PMC5391388 DOI: 10.1007/s11356-017-8798-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 03/09/2017] [Indexed: 05/16/2023]
Abstract
Venison is an attractive product for consumers concerned with healthy lifestyle; however, it can contain high levels of toxic elements, and therefore, it is a possible source of hazardous contaminants in human diet. Antlers are suitable bioindicators of environmental metal contamination, and herein, we assessed the ability of trace element levels in antlers to indicate levels in edible soft tissues. We determined the concentrations of lead (Pb), cadmium (Cd), mercury (Hg), arsenic (As), copper (Cu), zinc (Zn), and iron (Fe) in the liver, kidney, muscle, and antlers of 14 free-ranging red deer (Cervus elaphus) from northeastern Poland using atomic absorption spectrometry. We found the highest concentrations of Pb (0.321 ± 0.165 mg/kg), As (0.045 ± 0.074 mg/kg), Zn (105.31 ± 16.33 mg/kg), and Fe (220.92 ± 117.18 mg/kg) in antlers; of Cd (4.974 ± 1.90 mg/kg) and Hg (0.048 ± 0.102 mg/kg) in kidney; and of Cu (7.29 ± 7.02 mg/kg) in the liver. A positive relationship between concentrations in antlers and muscle was found only for Cu (p = 0.001), and it therefore appears that red deer antlers cannot be used as an index for element concentrations in soft tissues. While our results confirm that the Mazury region is little polluted, consumption of red deer offal from this area should be limited according to extant legal limits set for livestock consumption.
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Affiliation(s)
- Aleksandra Giżejewska
- Department of Pharmacology and Toxicology, Faculty of Veterinary Medicine, University of Warmia and Mazury, Oczapowskiego 14, 10-719, Olsztyn, Poland
| | - Józef Szkoda
- The National Veterinary Research Institute, 57 Partyzantów Avenue, 24-100, Puławy, Poland
| | - Agnieszka Nawrocka
- The National Veterinary Research Institute, 57 Partyzantów Avenue, 24-100, Puławy, Poland
| | - Jan Żmudzki
- The National Veterinary Research Institute, 57 Partyzantów Avenue, 24-100, Puławy, Poland
| | - Zygmunt Giżejewski
- Institute of Animal Reproduction and Food Research of Polish Academy of Sciences, Tuwima 10 Str, 10-748, Olsztyn, Poland.
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Ferri M, Baldi L, Cavallo S, Pellicanò R, Brambilla G. Wild game consumption habits among Italian shooters: relevance for intakes of cadmium, perfluorooctanesulphonic acid, and 137cesium as priority contaminants. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2017; 34:832-841. [PMID: 28271815 DOI: 10.1080/19440049.2017.1293303] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The consumption habits of 766 Italian shooters (96% males, 4% females), on average 52 years old, have been investigated, in Italy, through the distribution of questionnaires delivered during shooters' attendance to training and teaching courses, in compliance with 853/2004/EC Regulation provisions on food hygiene. The most consumed wild species recorded were pheasant > woodcock > choke among feathered animals, and wild boar > hare > roe deer among mammals, respectively. An average of 100-200 g game per serving (four servings per month) was consumed, with highest intakes of 3000 g per month; meat, liver, and heart were the preferred food items. Mammalian and feathered game was regularly consumed with friends and relatives in 83% and in 60% of cases, respectively. Accounting for an inventoried population of 751,876 shooters in Italy, it is estimated that there is regular consumption of wild game in around the 3% of the Italian population. More than 80% of responders were aware of health risks related to game handling and to food safety issues. Due to the occurrence in wild boar meat and liver of the heavy metal cadmium (Cd), the persistent organic pollutant perfluorooctan sulphonic acid (PFOS), and the radionuclide 137cesium (137Cs), it was possible to demonstrate the usefulness of such a food consumption database for intake assessment in this sensitive group of consumers. In high consumers of wild boar, threshold concentrations for intakes have been estimated in the ranges of 48-93 ng g-1 for Cd, 35-67 ng g-1 for PFOS and 0.20-0.34 Bq kg-1 for 137Cs.
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Affiliation(s)
- Mauro Ferri
- a Servizi Veterinari , Azienda Unità Sanitaria Locale di Modena , Modena , Italy
| | - Loredana Baldi
- b Osservatorio Regionale Sicurezza Alimentare , Istituto Zooprofilattico Sperimentale del Mezzogiorno , Portici (Naples) , Italy
| | - Stefania Cavallo
- b Osservatorio Regionale Sicurezza Alimentare , Istituto Zooprofilattico Sperimentale del Mezzogiorno , Portici (Naples) , Italy
| | - Roberta Pellicanò
- b Osservatorio Regionale Sicurezza Alimentare , Istituto Zooprofilattico Sperimentale del Mezzogiorno , Portici (Naples) , Italy
| | - Gianfranco Brambilla
- c Dipartimento Alimenti, Nutrizione e Sanità Pubblica Veterinaria , Istituto Superiore di sanità , Rome , Italy
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24
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Stokke S, Brainerd S, Arnemo JM. Metal deposition of copper and lead bullets in moose harvested in Fennoscandia. WILDLIFE SOC B 2017. [DOI: 10.1002/wsb.731] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Sigbjørn Stokke
- Norwegian Institute for Nature Research; P.O. Box 8685 Sluppen NO-7485 Trondheim Norway
| | - Scott Brainerd
- Alaska Department of Fish and Game; Division of Wildlife Conservation; 1300 College Road Fairbanks AK 99701 USA
- Department of Ecology and Natural Resource Management; Norwegian University of Life Sciences; P.O. Box 5003, NO-1432 Ås Norway
| | - Jon M. Arnemo
- Department of Forestry and Wildlife Management; Hedmark University of Applied Sciences Campus Evenstad, NO-2480 Koppang Norway
- Department of Wildlife, Fish, and Environmental Studies; Swedish University of Agricultural Sciences; SE-90183 Umeå Sweden
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Kollander B, Widemo F, Ågren E, Larsen EH, Loeschner K. Detection of lead nanoparticles in game meat by single particle ICP-MS following use of lead-containing bullets. Anal Bioanal Chem 2016; 409:1877-1885. [DOI: 10.1007/s00216-016-0132-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 11/23/2016] [Accepted: 12/02/2016] [Indexed: 11/28/2022]
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26
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Kanstrup N, Thomas VG, Krone O, Gremse C. Response to "Consumption of wild-harvested meat from New Zealand feral animals provides a unique opportunity to study the health effects of lead exposure in hunters" by Buenz et al. AMBIO 2016; 45:632-633. [PMID: 27344322 PMCID: PMC4980322 DOI: 10.1007/s13280-016-0803-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Niels Kanstrup
- Danish Academy of Hunting, Skrejrupvej 31, 8410 Rønde, Denmark
| | - Vernon G. Thomas
- Department of Integrative Biology, University of Guelph, Guelph, ON N1G 2W1 Canada
| | - Oliver Krone
- Department of Wildlife Diseases, Leibniz Institute for Zoo and Wildlife Research, P.O. 601103, 10252 Berlin, Germany
| | - Carl Gremse
- Wildlife Department, Eberswalde-University, Schicklerstrasse 5, 16225 Eberswalde, Germany
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27
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Høgåsen HR, Ørnsrud R, Knutsen HK, Bernhoft A. Lead intoxication in dogs: risk assessment of feeding dogs trimmings of lead-shot game. BMC Vet Res 2016; 12:152. [PMID: 27457446 PMCID: PMC4960786 DOI: 10.1186/s12917-016-0771-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 07/13/2016] [Indexed: 12/05/2022] Open
Abstract
Background Expanding lead-based bullets, commonly used for hunting of big game, produce a scattering of lead particles in the carcass around the wound channel. Trimmings around this channel, which are sometimes fed to dogs, may contain lead particles. The aim of this study was to assess potential health effects of feeding dogs such trimmings. Results Lead ingestion most commonly causes gastrointestinal and neurological clinical signs, although renal, skeletal, haematological, cardiovascular and biochemical effects have also been reported. Experimental data indicate that a daily dose of around 1 mg lead as lead acetate/kg body weight for ten days may be considered as a Lowest Observed Effect Level in dogs. Acute toxicity documentation from the Centers for Disease Control and Prevention indicates 300 mg/kg body weight as the lowest dose of lead acetate causing death in dogs after oral ingestion. Our assessment suggests that dogs fed trimmings of lead-shot game may be affected by the amounts of lead present, and that even deadly exposure could occasionally occur. The intestinal absorption of lead from bullets was assumed to be 10–80 % of that of lead acetate, reflecting both the variability in particle size and uncertainty about the bioavailability of metallic lead in dogs. Conclusions Despite data gaps, this study indicates that feeding dogs trimmings of lead-shot game may represent a risk of lead intoxication. More research is needed to assess the exact consequences, if lead-based bullets are still to be used. Meanwhile, we recommend that trimmings close to the wound channel should be made inaccessible to dogs, as well as to other domestic or wild animals.
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Affiliation(s)
- Helga R Høgåsen
- Norwegian Veterinary Institute, P.O. box 750, Sentrum, NO-0106, Oslo, Norway
| | - Robin Ørnsrud
- National Institute of Nutrition and Seafood Research (NIFES), P.O. box 2029, Nordnes, 5817, Bergen, Norway
| | - Helle K Knutsen
- Norwegian Institute of Public Health, P.O. box 4404, Nydalen, 0403, Oslo, Norway.
| | - Aksel Bernhoft
- Norwegian Veterinary Institute, P.O. box 750, Sentrum, NO-0106, Oslo, Norway
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28
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Fachehoun RC, Lévesque B, Dumas P, St-Louis A, Dubé M, Ayotte P. Lead exposure through consumption of big game meat in Quebec, Canada: risk assessment and perception. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2015; 32:1501-11. [DOI: 10.1080/19440049.2015.1071921] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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29
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Veyhe AS, Hofoss D, Hansen S, Thomassen Y, Sandanger TM, Odland JØ, Nieboer E. The Northern Norway Mother-and-Child Contaminant Cohort (MISA) Study: PCA analyses of environmental contaminants in maternal sera and dietary intake in early pregnancy. Int J Hyg Environ Health 2014; 218:254-64. [PMID: 25556042 DOI: 10.1016/j.ijheh.2014.12.001] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 11/17/2014] [Accepted: 12/01/2014] [Indexed: 11/18/2022]
Abstract
BACKGROUND Although predictors of contaminants in serum or whole blood are usually examined by chemical groups (e.g., POPs, toxic and/or essential elements; dietary sources), principal component analysis (PCA) permits consideration of both individual substances and combined variables. OBJECTIVES Our study had two primary objectives: (i) Characterize the sources and predictors of a suite of eight PCBs, four organochlorine (OC) pesticides, five essential and five toxic elements in serum and/or whole blood of pregnant women recruited as part of the Mother-and-Child Contaminant Cohort Study conducted in Northern Norway (The MISA study); and (ii) determine the influence of personal and social characteristics on both dietary and contaminant factors. METHODS Recruitment and sampling started in May 2007 and continued for the next 31 months until December 2009. Blood/serum samples were collected during the 2nd trimester (mean: 18.2 weeks, range 9.0-36.0). A validated questionnaire was administered to obtain personal information. The samples were analysed by established laboratories employing verified methods and reference standards. PCA involved Varimax rotation, and significant predictors (p≤0.05) in linear regression models were included in the multivariable linear regression analysis. RESULTS When considering all the contaminants, three prominent PCA axes stood out with prominent loadings of: all POPs; arsenic, selenium and mercury; and cadmium and lead. Respectively, in the multivariate models the following were predictors: maternal age, parity and consumption of freshwater fish and land-based wild animals; marine fish; cigarette smoking, dietary PCA axes reflecting consumption of grains and cereals, and food items involving hunting. PCA of only the POPs separated them into two axes that, in terms of recently published findings, could be understood to reflect longitudinal trends and their relative contributions to summed POPs. CONCLUSIONS The linear combinations of variables generated by PCA identified prominent dietary sources of OC groups and of prominent toxic elements and highlighted the importance of maternal characteristics.
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Affiliation(s)
- Anna Sofía Veyhe
- Department of Community Medicine, Faculty of Health Science, The Arctic University of Norway, Norway.
| | - Dag Hofoss
- Department of Community Medicine, Faculty of Health Science, The Arctic University of Norway, Norway; Institute of Health and Society, University of Oslo, Norway
| | - Solrunn Hansen
- Department of Community Medicine, Faculty of Health Science, The Arctic University of Norway, Norway
| | | | - Torkjel M Sandanger
- Department of Community Medicine, Faculty of Health Science, The Arctic University of Norway, Norway; Norwegian Institute for Air Research (NILU), Fram Centre, Tromsø, Norway
| | - Jon Øyvind Odland
- Department of Community Medicine, Faculty of Health Science, The Arctic University of Norway, Norway
| | - Evert Nieboer
- Department of Community Medicine, Faculty of Health Science, The Arctic University of Norway, Norway; Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
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