Body burdens, sources and interrelations of selected toxic and essential elements among the nine Cree First Nations of Eeyou Istchee, James Bay region of northern Quebec, Canada

Chemical contaminants in blood and their implications in chronic diseases

Artificial chemical products are widely used and ubiquitous worldwide and pose a threat to the environment and human health. Accumulating epidemiological and toxicological evidence has elucidated the contributions of environmental chemical contaminants to the incidence and development of chronic diseases that have a negative impact on quality of life or may be life-threatening. However, the pathways of exposure to these chemicals and their involvements in chronic diseases remain unclear. We comprehensively reviewed the research progress on the exposure risks of humans to environmental contaminants, their body burden as indicated by blood monitoring, and the correlation of blood chemical contaminants with chronic diseases. After entering the human body through various routes of exposure, environmental contaminants are transported to target organs through blood circulation. The application of the modern analytical techniques based on human plasma or serum specimens is promising for determining the body burden of environmental contaminants, including legacy persistent organic pollutants, emerging pollutants, and inorganic elements. Furthermore, their body burden, as indicated by blood monitoring correlates with the incidence and development of metabolic syndromes, cancers, chronic nervous system diseases, cardiovascular diseases, and reproductive disorders. On this basis, we highlight the urgent need for further research on environmental pollution causing health problems in humans.

Sources of exposure to lead in Arctic and subarctic regions: a scoping review

Understanding lead exposure pathways is a priority because of its ubiquitous presence in the environment as well as the potential health risks. We aimed to identify potential lead sources and pathways of lead exposure, including long-range transport, and the magnitude of exposure in Arctic and subarctic communities. A scoping review strategy and screening approach was used to search literature from January 2000 to December 2020. A total of 228 academic and grey literature references were synthesised. The majority of these studies (54%) were from Canada. Indigenous people in Arctic and subarctic communities in Canada had higher levels of lead than the rest of Canada. The majority of studies in all Arctic countries reported at least some individuals above the level of concern. Lead levels were influenced by a number of factors including using lead ammunition to harvest traditional food and living in close proximity to mines. Lead levels in water, soil, and sediment were generally low. Literature showed the possibility of long-range transport via migratory birds. Household lead sources included lead-based paint, dust, or tap water. This literature review will help to inform management strategies for communities, researchers, and governments, with the aim of decreasing lead exposure in northern regions.

A probabilistic hazard and risk assessment of exposure to metals and organohalogens associated with a traditional diet in the Indigenous communities of Eeyou Istchee (northern Quebec, Canada)

Hunting, trapping, and fishing are part of an Indigenous lifestyle in subarctic Canada. However, this lifestyle may be a route of exposure to contaminants and may pose a risk for the people who rely on a subsistence diet. Monte Carlo simulations for the chemical concentration of eight game species and one fish species were carried out by randomly sampling 10,000 samples from the contaminant measures for each species. We then calculated a probabilistic non-carcinogenic hazard quotient or carcinogenic risk values to estimate the human health risk of exposure to contaminants. Of the species examined, ducks were of concern for potential carcinogenic risk. There was a modeled probabilistic 95th-percentile risk associated with the consumption of ducks and polybrominated biphenyl (PBB) congener 153 in boys, women, and men (1.09 × 10-6, 1.57 × 10-6, and 2.17 × 10-6, respectively) and, to a lesser extent, with geese and polychlorinated biphenyl (PCB) congener 153 in men (1.19 × 10-6). Contaminant concentration in the intake rate (food consumption) for PBB congener 153 exposure risk was more important than that for PCB congener 153, where intake rate had greater relevance. The consumption of waterfowl may increase the exposure to organohalogens; however, there are health and wellness benefits associated with the harvesting and consumption of subsistence foods that must also be considered. We recommend follow-up species-specific studies focused on ducks to clarify and elucidate the results in the present study.

Levels of Toxic and Essential Elements and Associated Factors in the Hair of Japanese Young Children

There is growing concern regarding the effects of toxic element exposure on the development of children. However, little is known about the level of toxic elements exposure in Japanese children. The purpose of this study was to assess the concentrations of multiple elements (aluminum, cadmium, lead, calcium, copper, iron, magnesium, sodium, zinc) in the hair of 118 Japanese young children and to explore the factors associated with their element levels. The element concentration was analyzed by ICP-MS, and children's food and water intake were assessed by the questionnaire. Results showed that there were no large differences between the level of elements in the hair of Japanese children and those of children in other developed countries. Girls had significantly higher levels of aluminum, copper, and iron (p = 0.000, 0.014, and 0.013, respectively), and boys had a higher level of sodium (p = 0.006). The levels of calcium, iron, magnesium, and sodium in nursery school children were significantly higher than those in kindergarten children (p = 0.024, 0.001, 0.046, and 0.029, respectively). Multiple regression analyses with controlling the confounding variables showed significant negative associations of frequency of yogurt intake with aluminum and lead levels (p = 0.015 and 0.037, respectively). When the children were divided into three groups based on the frequency of yoghurt consumption, viz. L (≤once a week), M (2 or 3 times a week), and H (≥4 to 6 times a week) group, the mean aluminum concentration (µg/g) in the L, M, and H groups was 11.06, 10.13, and 6.85, while the mean lead concentration (µg/g) was 1.76, 1.70, and 0.87, respectively. Our results suggested the validity of hair element concentrations as an exposure measure of essential elements and frequent yogurt intake as a viable measure for protecting children from toxic elements. However, these findings will need to be confirmed in more detailed studies with larger sample sizes in the future.

Environmental contaminants and the disproportionate prevalence of type-2 diabetes mellitus among Indigenous Cree women in James Bay Quebec, Canada

Indigenous populations are disproportionately affected by type 2 diabetes (T2DM) compared to non-Indigenous people. Of importance, the prevalence of T2DM is greater amongst females than males in First Nations communities, in contrast to higher male prevalence reported in non-Indigenous Canadians. Therefore, in this study we extend our previously published work with respect to females, and the potential association between environmental exposures to organochlorine pesticides, such as dichlorodiphenyltrichloroethane (DDT), and dichlorodiphenyldichloroethylene (DDE) to explain the greater prevalence of T2DM among Indigenous females compared to males. Using data from the Multi-Community Environment-and-Health Study, Principal Component Analysis (PCA), examined 9-polychlorinated biphenyl congeners, 7-organic pesticides, and 4-metal/metalloids. Modified Poisson regression with robust error variance estimated adjusted prevalence ratios (PR) and corresponding 95% confidence intervals (95% CI), regressing prevalent T2DM on the newly derived principal components (PC), adjusting for a priori covariates, including parity. We further examined the relationship between high detection concentrations of DDT and tertials of categorized DDE exposures on T2DM among Indigenous Cree women. Among 419 female participants, 23% (n = 95) had physician-diagnosed T2DM. PCA analysis show that DDT and Lead (Pb) loaded highly on the second axis (PC-2), although in opposite directions, indicating the different exposure sources. As previously published, T2DM was significantly associated with PC-2 across adjusted models, however, after further adjusting for parity in this analysis, T2DM was no longer significantly associated with increasing PC-2 scores (PR = 0.88, 95% 0.76, 1.03). Furthermore, we found that the highest detectable levels of DDT, and tertiles of DDE were significantly associated with prevalent T2DM in the fully adjusted model (PR = 1.93, 1.17, 3.19), and (PR = 3.58, 1.10, 11.70), respectively. This cross-sectional analysis suggests organochlorines, specifically, detectable high exposure concentrations of DDT and DDE are associated with prevalent type 2 diabetes, signifying a possible important link between parity and environmental organochlorines pesticides among Indigenous Cree women.

Two-Eyed Seeing and developmental origins of health and disease studies with indigenous partners

Globally, mortality of Indigenous persons is greater than that of their non-Indigenous counterparts, which has been shown to be disproportionately attributable to non-communicable diseases. The historically subordinate position that Indigenous Knowledge (IK) held in comparison to Western science has shifted over the last several decades, with the credibility and importance of IK now being internationally recognized. Herein, we examine how Marsahall's (2014) Two-Eyed Seeing can foster collaborative and culturally relevant Developmental Origins of Health and Disease (DOHaD) studies for health and well-being by using '..the best in Indigenous ways of knowing…[and] the best in Western (or mainstream) ways of knowing…and learn to use both these eyes for the benefit of all.' At its core, Two-Eyed Seeing also includes the principles of ownership, control, access and possession, and Community-Based Participatory Research, which further reinforces the critical role of Indigenous peoples taking active roles in DOHaD research. Additionally, we also present a partnership model for working with Indigenous communities that includes the principles of respect, equity and empowerment. As researchers begin to fill the gap in Indigenous health, we outline how Two-Eyed Seeing should form the basis of DOHaD studies involving Indigenous communities. This model can be used to develop and guide projects that result in robust and meaningful participatory partnerships that have impactful uptake of research findings.

Environmental Contaminant Body Burdens and the Relationship with Blood Pressure Measures Among Indigenous Adults

Supplemental Digital Content is available in the text.

Blood pressure (BP) increase cardiovascular disease (CVD) risk. Indigenous Canadians experience slightly higher CVD compared with nonIndigenous Canadians. This study examined the role of polychlorinated biphenyls (PCBs), other organic compound concentrations (OCs), and toxic metals on blood pressure measures among Indigenous Canadians.

Heart rate variation and human body burdens of environmental mixtures in the Cree First Nation communities of Eeyou Istchee, Canada

INTRODUCTION

Heart rate variability (HRV) is a measure of cardiac autonomic regulation that examines the variation in beat-to-beat fluctuations in heart rate. While many exposure-based studies have examined the effects of single or similar groups of contaminants on HRV parameters, none have examined the association between complex environmental mixtures, including organic and elemental contaminants, and HRV.

METHODS

Using data collected from the Multi-Community Environment-and-Health Study in Eeyou Istchee (Quebec, Canada), we assessed HRV in two time domain measures: root mean square of successive differences (RMSSD) and standard deviation of the N-N (RR) intervals (SDNN); and in three frequency domains: high frequency (HF), low-frequency (LF), and very-low frequency (VLF) in 443 participants. We first examined mixture effects of nineteen organic and metal contaminants in blood using principal component analysis (PCA) and a multivariable general linear regression on HRV responses, adjusting for age, sex, body mass index, smoking status, and kidney disease covariates. We subsequently assessed HRV outcome response variables using Bayesian kernel machine regression (BKMR) to further examine individual contaminant contribution and overall mixture effects.

RESULTS

In the PCA, a significant positive association was observed between RMSSD and principal component (PC) axis 2, which was highly positively-loaded for nickel and moderately negatively-loaded for mercury. A negative association between SDNN and PC-1, which was highly positively-loaded for all PCBs (polychlorinated biphenyls) and organochlorines and moderately positively-loaded for mercury, was observed. Additionally, a significant and positive association was observed between PC-2 and SDNN and a significant and negative association between PC-3 (negatively loaded for cadmium) and LF. Associations with contaminants were not observed for HF or VLF. BKMR results suggest that trans-nonachlor and cis-nonachlor are primarily responsible for reductions in HRV; however, their contributions to HRV deficits was non-significant when examined as a complete mixture.

CONCLUSIONS

While PCA results suggested that organochlorines, mercury, nickel, and cadmium may all play a role in altering various HRV, subsequent BKMR analysis illustrated the individual components driving these effects may be trans- and cis-nonachlor and nickel and likely not mercury or cadmium. However, other contaminants appear to temper this effect when the entire mixture of chemicals is assessed as a whole. This study expands our knowledge of the effects of environmental contaminant mixtures on HRV, which is especially important in exposed populations such as those in the Eeyou Istchee territory, whilst utilizing novel statistical methods such as PCA and BKMR to examine co-exposures concurrently.

Potential obesogenic effect of a complex contaminant mixture on Cree First Nations adults of Northern Québec, Canada

BACKGROUND

Obesity incidence and prevalence is of increasing concern in First Nations communities around Canada. In addition to diet and physical activity, environmental pollutants have been suggested as a potential contributory factor to obesity associated morbidity. Owing to the exposure of Cree First Nations people to various persistent organic pollutants (POPs) and toxic metals, it is important to examine the association between obesity in these communities, and contaminant body burdens.

OBJECTIVE

To determine whether selected morphometry measures (body mass index [BMI], waist circumference [WC] and body fat percentage) are associated with body burdens of 10 POPs and toxic metals.

METHODS

Using data from the Nituuchischaayihtitaau Aschii Multi-community Environment-and-Health study in the eastern James Bay (Eeyou Istchee) Cree communities, this cross-sectional study examined morphometric and contaminant measures of 695 eligible participants. Sex stratified principal component analysis was conducted on blood plasma concentrations of 10 POPs and toxic metals. BMI, WC, body fat percent, and resultant contaminant components were used to create generalized linear models, and adjusted for covariates (age, total lipids, smoking, and n-3 fatty acids).

RESULTS

Two principal components (PCs; PC-1 and PC-2) were extracted for both males and females. For females, PC-1 explained 73.3% and PC-2 explained 10.5%, and for males, PC-1 explained 71.6% and PC-2 explained 11.2% of the variance in contaminant burden. For both sexes, PC-1 loaded highly for polychlorinated biphenyl (PCB) congeners, organochlorine pesticides and, to a lesser extent, mercury and lead. PC-2 loaded highly for cadmium for females, and cadmium and lead for males. After adjusting for covariates, the generalized linear model showed that PC-2 was significantly and negatively associated with BMI, body fat percent, and WC in males and females.

CONCLUSIONS

Our cross-sectional analysis indicates a negative association between cadmium with various obesity measures in both males and females. Null associations were found between PCBs and organochlorine pesticides and morphometry.

Complex contaminant mixtures and their associations with intima-media thickness

BACKGROUND

The burden of cardiovascular disease (CVD) morbidity and mortality is higher among Indigenous persons, who also experience greater health disparities when compared to non-Indigenous Canadians, particularly in remote regions of Canada. Assessment of carotid intima-media thickness (cIMT), a noninvasive screening tool and can be used as biomarker to assess increased CVD risk. Few studies have examined environmental contaminant body burden and its association with cIMT.

METHODS

Data from the Environment-and-Health Study in the Eeyou Istchee territory of northern Québec, Canada was used to assess complex body burden mixtures of POPs, metals and metalloids among (n = 535) Indigenous people between 15 and 87 years of age with cIMT. First, Principal Component Analysis (PCA) was used to reduce the complexity of the contaminant data. Second, based on the underlying PCA profiles from the biological data, we examined each of the prominent principal component (PC) axes on cIMT using multivariable linear regression models. Lastly, based on these PC axes, cIMT was also regressed on summed (Σ) organic compound concentrations, polychlorinated biphenyl, perfluorinated compounds, respectively, ∑10 OCs, ∑13 PCBs, ∑3PFCs, and nickel.

RESULTS

Most organochlorines and PFCs loaded primarily on PC-1 (53% variation). Nickel, selenium, and cadmium were found to load on PC-5. Carotid-IMT was significantly associated with PC-1 β = 0.004 (95 % CI 0.001, 0.007), and PC-5 β = 0.013 (95 % CI 0.002, 0.023). However, the association appears to be greater for PC-5, accounting for 3% of the variation, and mostly represented by nickel. Results show that that both nickel, and ∑3PFCs were similarly associated with cIMT β = 0.001 (95 % CI 0.0003, 0.003), and β = 0.001 (95 % CI 0.0004, 0.002), respectively. But ∑10OCs was significantly associated with a slightly greater β = 0.004 (95 % CI 0.001, 0.007) cIMT change, though with less precision. Lastly, ∑13PCBs also increased β = 0.002 (95 % CI 0.0004, 0.003) cIMT after fully adjusting for covariates.

CONCLUSION

Our results suggest that environmental contaminants are associated with cIMT. This is important for the Cree from the Eeyou Istchee territory who may experience higher body burdens of contaminants than non-Indigenous Canadians.

Examining environmental contaminant mixtures among adults with type 2 diabetes in the Cree First Nation communities of Eeyou Istchee, Canada

Type 2 diabetes mellitus (T2DM) disproportionately affects Indigenous populations. It is possible that exposure to complex mixtures of environmental contaminants contribute to T2DM development. This study examined the association between complex environmental contaminant mixtures and T2DM among Canadian Indigenous communities from the Eeyou Istchee territory, Quebec, Canada. Using data from the cross-sectional Multi-Community Environment-and-Health Study (2005–2009) Principal Component Analysis (PCA) was used to reduce the dimensionality of the following contaminants: 9-polychlorinated biphenyl congeners; 7-organic pesticides; and 4-metal/metalloids. Following this data reduction technique, we estimated T2DM prevalence ratios (PR) and 95% confidence intervals using modified Poisson regression with robust error variance across derived principal components, adjusting for a priori covariates. For both First Nation adult males (n = 303) and females (n = 419), factor loadings showed dichlorodiphenyltrichloroethane (DDT) and lead (Pb) highly loaded on the second principal component (PC) axis: DDT negatively loaded, and Pb positively loaded. T2DM was significantly associated with PC-2 across all adjusted models. Because PCA produces orthogonal axes, increasing PC-2 scores in the fully adjusted model for females and males showed (PR = 0.84; 95% CI 0.72, 0.98) and (PR = 0.78; 95% CI 0.62, 0.98), respectively. This cross-sectional study suggests that our observed association with T2DM is the result of DDT, and less likely the result of Pb exposure. Further, detectable levels of DDT among individuals may possibly contribute to disease etiology.

Blood and hair mercury concentrations among Cree First Nations of Eeyou Istchee (Quebec, Canada): time trends, prenatal exposure and links to local fish consumption

To describe exposure to methylmercury among Cree, focusing on women of childbearing age, we used data from 2 studies. Multiple regression was employed to examine associations between blood and hair mercury concentrations and consumption of locally harvested fish. Approximately 9.9% of non-pregnant women aged 15-44 y and 3.9% of pregnant women required follow-up according to Health Canada's blood mercury guidance value of 40 nmol/L. 8% of hair mercury observations in the non-pregnant women and 2.5% among pregnant women exceeded the equivalent threshold of 10 nmol/g. The geometric mean blood mercury concentration was 12.7 nmol/L in 1,429 persons aged 8 and over, and 17.7 nmol/L in adults aged 18 and older. The proportion of hair mercury concentrations greater than 12.5 nmol/g decreased in all age-sex groups when comparing the 2002-2009 data to published values for 1993-1994. Among women of childbearing age, local fish consumption was associated with increased blood and hair mercury concentrations. While over 90% of women of childbearing age in this population have acceptable levels of mercury, ongoing intake of mercury suggests that their consumption of fish with known high mercury content be minimised. Reducing consumption of fish known to be high in mercury content needs to be balanced with promoting ongoing connection to Cree culture and land-based activities that are also important determinants of health.

The Argentinian mother-and-child contaminant study: a cross-sectional study among delivering women in the cities of Ushuaia and Salta

Several ongoing international multidisciplinary projects have examined linkages between environmental chemicals and health. In contrast to Arctic regions, information for the Southern Hemisphere is scarce. Because of the inherent practice of pesticide utilisation and mismanagement, food security is potentially threatened. The most vulnerable period in human life occurs during pregnancy and early childhood, thus a focus on the body burdens of PTS in pregnant or delivering women is warranted. The current study was designed to investigate health risks related to exposure to PTS and food security in two regions of Argentina (Ushuaia and Salta). Our aims were to quantify concentrations of organic and inorganic toxins in serum or whole blood of delivering women and to collect pertinent dietary and medical information. The overall study design, the basic demographic features and essential clinical chemistry findings are described in the current paper. The socioeconomic differences between the two study areas were evident. On average, the women in Ushuaia were 4 years older than those in Salta (28.8 vs. 24.7 years). Respectively, the proportion of current smokers was 4.5 vs. 9.6%; and Salta had a higher birth rate, with 15.6% being para four or more. Saltanean women reported longer breastfeeding periods. Caesarean sections were more frequent in Ushuaia, with 43% of Caesarean deliveries compared with only 6% in Salta. Employment was high in both communities. Recognised environmental pollution sources in the vicinity of participant dwellings were widespread in Salta (56.1%) compared to Ushuaia (9%). The use of pesticides for insect control in homes was most common in Salta (80%). There is an urgent need for a comprehensive assessment of exposures in areas of the Southern Hemisphere. Our data set and the planned publications of observed concentrations of inorganic and organic environmental contaminants in both mothers and their newborns will contribute to this objective.