A population-based mercury exposure assessment near an artisanal and small-scale gold mining site in the Peruvian Amazon

Heavy Metal Bioaccumulation in Peruvian Food and Medicinal Products

To better query regional sources of metal(loid) exposure in an under-communicated region, available scientific literature from 50 national universities (undergraduate and graduate theses and dissertations), peer-reviewed journals, and reports published in Spanish and English were synthesized with a focus on metal(loid) bioaccumulation in Peruvian food and medicinal products utilized locally. The study considered 16 metal(loid)s that are known to exert toxic impacts on humans (Hg, Al, Sb, As, Ba, Be, Cd, Cr, Sn, Ni, Ag, Pb, Se, Tl, Ti, and U). A total of 1907 individual analyses contained within 231 scientific publications largely conducted by Peruvian universities were analyzed. These analyses encompassed 239 reported species classified into five main food/medicinal groups-plants, fish, macroinvertebrates and mollusks, mammals, and "others" category. Our benchmark for comparison was the World Health Organization (Codex Alimentarius) standards. The organisms most frequently investigated included plants such as asparagus, corn, cacao, and rice; fish varieties like trout, tuna, and catfish; macroinvertebrates and mollusks including crab and shrimp; mammals such as alpaca, cow, chicken eggs, and milk; and other categories represented by propolis, honey, lichen, and edible frog. Bioaccumulation-related research increased from 2 to more than 25 publications per year between 2006 and 2022. The results indicate that Peruvian food and natural medicinal products can have dangerous levels of metal(loid)s, which can cause health problems for consumers. Many common and uncommon food/medicinal products and harmful metals identified in this analysis are not regulated on the WHO's advisory lists, suggesting the urgent need for stronger regulations to ensure public safety. In general, Cd and Pb are the metals that violated WHO standards the most, although commonly non-WHO regulated metals such as Hg, Al, As, Cr, and Ni are also a concern. Metal concentrations found in Peru are on many occasions much higher than what has been reported elsewhere. We conclude that determining the safety of food/medicinal products is challenging due to varying metal concentrations that are influenced not only by metal type but also geographical location. Given the scarcity of research findings in many regions of Peru, urgent attention is required to address this critical knowledge gap and implement effective regulatory measures to protect public health.

Emerging mercury and methylmercury contamination from new artisanal and small-scale gold mining along the Nile Valley, Egypt

The past decade witnessed the initiation and boom of the Artisanal and Small-scale Gold Mining (ASGM) activities in the hyper-arid southern Egypt. The ores are mined in the Eastern Desert and then transported to the densely populated farming communities in the Nile Valley, where the river provides the water resources needed for ore processing. In search for economic benefits, the poorly educated farmers with limited technical resources transformed their cultivated lands into ASGM operations, exposing themselves, their families, the residents, and the Nile ecosystems to several environmental and occupational health problems. Using integrated remote sensing, field, geochemical, and isotopic analyses, we report the first inventory of ASGM-related total mercury (THg) and methylmercury (MeHg) levels in tailings, amalgamation-tailing ponds, and surface and groundwater with emphasis on the Edfu city and its surroundings. The field and remote sensing-based mapping of ASGM activities reveals clustering around the Nile waterways and suggests interaction of Hg contamination sources with their surrounding receptors. Common ASGM practices include release of contaminated water from unlined amalgamation-tailing ponds into irrigation and drainage canals, and spreading of tailings over cultivated soils. In a short period (10 years), the released Hg contaminated multiple media, including the surface water, the shallow and deep aquifers, and possibly the soil, crops, and livestock. THg levels in amalgamation-tailing ponds (1200-8470 ng/L) are fourfold higher than US EPA and eightfold the WHO thresholds. The contaminated waters released from amalgamation-tailing ponds raised THg levels in surface water (irrigation canals: 50-100 ng/L; drainage canals: THg: > 200 ng/L) and groundwater (shallow and deep aquifers: 80-500 ng/L). Our findings highlight the need to extend the adopted approach to cover the entire length of the Nile River and its valley and the importance of conducting awareness campaigns to educate residents and health care providers about potential ASGM-related environmental and health hazards.

Lactic acid bacteria strains reduce in vitro mercury toxicity on the intestinal mucosa

A bicameral model consisting of Caco-2 and HT29-MTX intestinal epithelial cells and THP-1-derived macrophages has been used to test the ability of two strains of Lactobacillus to protect from damage caused by mercury. Exposure to 1 mg/ml mercury [Hg(II) or methyl-Hg] for seven days in this model resulted in an inflammatory and pro-oxidant response mainly driven by macrophages. This led to an impairment in the intestinal barrier, defective tight-junctions, increased permeability and mucus hypersecretion. In addition, the wound-healing capacity of the epithelial monolayer was also diminished. However, the presence of heat-killed Lactobacillus intestinalis or Lactobacillus johnsonii cells during Hg exposure reverted these effects, and most of the parameters recovered values similar to control cells. Both lactobacilli showed the capacity to bind Hg(II) and methyl-Hg under the cell culture conditions. This points to Hg sequestration as a likely mechanism that counteracted Hg toxicity. However, differences in the Hg binding capacity and in the effects between both strains suggest that other probiotic-mediated mechanisms may play a role in the alleviation of the damage elicited by Hg. These results show the potential of the bicameral intestinal epithelial model for screening of effective strains for their use in later in vivo studies.

Identifying contamination of heavy metals in soils of Peruvian Amazon plain: use of multivariate statistical techniques

The Peruvian Amazon plain has abundant natural resources and is home to great biodiversity, which makes it an area with high economic potential. However, the use of its resources through various activities has contributed to the release of heavy metals (HMs) into its soils, generating severe pollution problems which have mainly affected the health of local populations and their ecosystems. Currently, there are no comprehensive studies that have identified the specific sources of contamination by HMs in the soils of this part of the Peruvian territory. In this sense, this research aims to identify the possible sources of contamination by HMs in the soils of the Peruvian Amazon plain to focus efforts on the establishment of adequate measures for the protection of the health of people and the ecosystem. In the present study, samples of topsoils (0-20 cm depth) and subsoils (100-150 cm depth) were collected for the analysis of 11 HMs (Co, Cr, Cu, Fe, Mn, Ni, Pb, V, Zn, Be, and Hg) in 48 sites located in four regions of the Peruvian Amazon plain (Loreto, Amazonas, San Martín, and Ucayali), over the year 2019. The enrichment factor and geoaccumulation index were applied to assess contamination levels of HMs. The results indicated that topsoils and subsoils presented a greater enrichment by the elements Be and Pb, and were classified as moderately contaminated. Likewise, the integral analysis of these indexes together with principal component analysis, hierarchical cluster analysis, correlation analysis, and coefficient of variation allowed the identification of potential sources of contamination by HMs. As a result, Fe, Co, Zn, Ni, V, and Cr were associated with natural or lithogenic sources (parent material, crude oil deposits, and organic matter decomposition). Hg was attributed to anthropogenic sources (illegal gold mining, atmospheric deposition, and vehicle emissions). Be, Pb, Cu, and Mn originated from natural sources (parent material, crude oil deposits, decomposition of organic matter, and forest fires) and anthropogenic (areas degraded by solid waste, illegal gold mining, agriculture, and hydrocarbons). These findings provide essential information to establish regulations and prevent and control HM contamination in soils of the Peruvian Amazon plain.

Risk of lead exposure from wild game consumption from cross-sectional studies in Madre de Dios, Peru

Background

Methods

Findings

Interpretation

Global Health Impact of Atmospheric Mercury Emissions from Artisanal and Small-Scale Gold Mining

Artisanal and small-scale gold mining (ASGM) is the leading source of mercury (Hg), a global neurotoxin. Past research has focused on the health impacts on miners and nearby residents; here, we estimate the risk for global general populations by employing a comprehensive atmosphere-land-ocean-ecosystem and exposure-risk-valuation model framework. Our results suggest that ASGM sources contribute 12%, 10%, and 0.63% to the atmospheric Hg deposition, plankton methylmercury concentrations, and soil total Hg concentrations at present day, respectively, and cause 5.8×10⁵ points of intelligence quotient decrements and 1,430 deaths for global general populations per year. The monetized global health impact of ASGM ($154 billion) is 1.5 times its local impact and accounts for half of the total revenue of ASGM ($319 billion). A major spatial decoupling between the health impact and economic gains is also revealed, suggesting that intervention measures such as awareness-raising, capacity-building, and technology transfer funded by the Global North are cost-effective.

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Contributions of ASGM to MeHg concentrations in different organisms are calculated

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The global health impact of atmospheric Hg from ASGM is first revealed

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The health impacts and economic gains of ASGM are compared

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Intervention measures for ASGM are proved to be cost-effective

Efficacy of Hair Total Mercury Content as a Biomarker of Methylmercury Exposure to Communities in the Area of Artisanal and Small-Scale Gold Mining in Madre de Dios, Peru

Total mercury content (THg) in hair is an accepted biomarker for chronic dietary methylmercury (MeHg) exposure. In artisanal and small-scale gold mining (ASGM) communities, the validity of this biomarker is questioned because of the potential for contamination from inorganic mercury. As mining communities may have both inorganic and organic mercury exposures, the efficacy of the hair-THg biomarker needs to be evaluated, particularly as nations begin population exposure assessments under their commitments to the Minamata Convention. We sought to validate the efficacy of hair THg for public health monitoring of MeHg exposures for populations living in ASGM communities. We quantified both THg and MeHg contents in hair from a representative subset of participants (N = 287) in a large, population-level mercury exposure assessment in the ASGM region in Madre de Dios (MDD), Peru. We compared population MeHg-THg correlations and %MeHg values with demographic variables including community location, sex, occupation, and nativity. We observed that hair MeHg-THg correlations were high (r > 0.7) for all communities, regardless of location or nativity. Specifically, for individuals within ASGM communities, 81% (121 of 150 total) had hair THg predominantly in the form of MeHg (i.e., >66% of THg) and reflective of dietary exposure to mercury. Furthermore, for individuals with hair THg exceeding the U.S. EPA threshold (1.0 μg/g), 88 out of 106 (83%) had MeHg as the predominant form. As a result, had urine THg solely been used for mercury exposure monitoring, approximately 59% of the ASGM population would have been misclassified as having low mercury exposure. Our results support the use of hair THg for monitoring of MeHg exposure of populations in ASGM settings where alternative biomarkers of MeHg exposure are not feasible.

CoNaMad-Cohorte de Nacimiento de Madre de Dios/Madre de Dios Birth Cohort to Study Effects of in-utero Trace Metals Exposure in the Southern Peruvian Amazon

Background:

In-utero exposure to mercury and other trace metals pose a significant threat to child health and development, but exposures and health impacts in artisanal and small-scale gold mining (ASGM) environments are poorly defined.

Objectives:

We describe the CONAMAD study design, a prospective birth cohort consisting of multiparous women (18 and over) living in rural and peri-urban Peruvian Amazon communities exposed to ASGM.

Methods:

Pregnant women are enrolled from health posts across four zones of Madre de Dios, Peru. Data are collected at enrollment, childbirth, and (planned) 36-48 months. At enrollment, hair samples for mercury assessment, demographic and clinical data are obtained. At birth, we obtain venous and cord blood, placenta, hair, toenails, and saliva.

Findings:

Two hundred seventy mothers were enrolled at an average 20 weeks gestational age with no differences in maternal characteristics across zones. Two hundred fifteen mothers were successfully followed at birth. We obtained 214 maternal and cord blood samples, 211 maternal and 212 infant hair samples, 212 placenta samples, 210 infant saliva samples, and 214 infant dried blood spots. Data collected will allow for testing our primary hypotheses of maternal malnutrition modifying ratios of cord:maternal blood total mercury (tHg), cord blood:maternal hair tHg, and infant:maternal hair tHg, and whether chemical mixtures (Hg, Pb, Cd) have synergistic effects on infant neurodevelopment.

Conclusions:

CONAMAD is designed to collect and store samples for future processing and hypothesis testing associated with in-utero mercury exposure and child development. We have completed the exposure assessments and will conduct a follow-up of mothers to evaluate early child development outcomes, including developmental delay and growth. These data offer insights into disease mechanisms, exposure prevention, and policy guidance for countries where ASGM is prevalent.

Evaluation of Peruvian Government Interventions to Reduce Childhood Anemia

Background:

In Peru, anemia has been a persistent health problem that is known to lead to irreversible cognitive and developmental deficits in children. The Peruvian government has recently made anemia a primary health concern by passing legislation in 2017 that makes anemia an intersectoral priority. This new legislation fortifies previous programs while creating new programs that target specific age groups.

Objectives:

Evaluate the effectiveness of government programs in Madre de Dios, Peru to reduce anemia prevalence and increase hemoglobin levels among children ages 2–11 years old.

Methods:

Propensity scores are used to match 688 children enrolled in 2018, after the legislation, and 2,140 children enrolled in previous studies our team conducted in the region between 2014 and 2017, based on sex, age (years), intervention status (prior/post), community income, presence of a health post in the community (yes/no), community type (indigenous, non-indigenous rural, non-indigenous urban) and road access (fraction of the number of months out of the year with road access). A pseudo matched case-control analysis to evaluate changes in anemia prevalence and hemoglobin was conducted using t-tests and multivariate models. Program effectiveness is evaluated overall, by age groups (2–4, 5–7 and 8–11 years old), and community type (indigenous vs. urban).

Findings:

The adjusted odds ratio indicated lower odds of anemia (OR = 0.31, 95%CI 0.17–0.54) for children exposed to the anemia prevention programs vs. those not exposed. The effect was not significantly different across age groups; however, the intervention effects significantly differed by community type among children 8–11 years old, with urban children less likely to benefit from anemia interventions (OR = 0.69, 95% CI 0.38–1.25) compared to indigenous children (OR = 0.21, 95% CI 0.08–0.56).

Conclusion:

Government programs to reduce anemia in Madre de Dios were found to be associated with reduced anemia prevalence in the study communities. However, the lack of program monitoring precludes the attribution of anemia decline to specific interventions or program components. In addition, regional anemia prevalence remains high according to the 2019 Demographic and Health Survey, suggesting impaired population impact. Program monitoring and evaluation is a key component of health interventions to improve program implementation effectiveness.