Mercury levels in urine and hair of children in an Andean gold-mining settlement

Mercury pollution in Peru: geographic distribution, health hazards, and sustainable removal technologies

Peru is one of the great gold producers worldwide. However, a significant portion of the gold produced in Peru derives from artisanal small-scale gold mining (ASGM) in the Andes and Amazon. In ASGM, gold amalgamation with mercury (Hg) is a critical procedure to refine gold through the formation of Au-Hg alloys. Due to the rudimentary and improvised techniques conducted by small-scale and informal miners, Hg contamination has become of great concern and is strictly associated with ASGM. Multiple studies have evidenced notably high concentrations of Hg in consumable fish species, rivers, sediments, and air in locations where ASGM is one of the main sources of income to local communities and is carried out aggressively. In the present review, we have conducted a systematic search for national and international literature reporting the concentration and distribution of Hg pollution across environmental compartments, biota, and human samples in Peru. The results and data retrieved from the articles were quantitatively and qualitatively analyzed, and the distribution of Hg across environmental compartments was visualized through a geographic information system. Additionally, we reviewed the use of adsorption techniques as alternatives to treat Hg⁰ vapor from the gold shop and smelter flues, one of the main sources of hazardous levels of Hg exposure.

Biomonitoring of Mercury, Cadmium and Selenium in Fish and the Population of Puerto Nariño, at the Southern Corner of the Colombian Amazon

Heavy metals threaten communities near biodiversity hotspots, as their protein sources come from the environment. This study assessed Hg, Cd, and Se concentrations in fish, as well as the magnitude of exposure and hematological conditions of adult citizens from Puerto Nariño (Colombian Amazon). Among fish samples, greater Hg concentrations were found in higher trophic level species, including Rhaphiodon vulpinus (880 ± 130 ng/g) and Pseudoplatystoma tigrinum (920 ± 87 ng/g). These species presented the highest hazard quotients and lowest Se:Hg molar ratios among those studied, showing their consumption represents a health risk to consumers. Moreover, some samples of Mylossoma duriventre and Prochilodus magdalenae had Cd levels greater than the regulated limit (100 ng/g). The average total Hg (T-Hg) concentrations in human hair and blood were 5.31 µg/g and 13.7 µg/L, respectively. All hair samples exceeded the 1.0 μg/g threshold set by the USEPA, whereas 93% of the volunteers had T-Hg blood levels greater than 5 μg/L, suggesting elevated exposure. The mean Cd level was 3.1 µg/L, with 21% of samples surpassing 5 µg/L, value at which mitigating actions should be taken. Eighty-four percent of participants presented Se deficiencies (<100 μg/L). There was a significant association between fish consumption and T-Hg in hair (ρ = 0.323; p = 0.032) and blood (ρ = 0.381; p = 0.011). In this last matrix, Se correlated with Cd content, whereas lymphocytes were inversely linked to Hg concentrations. The results of this study show that there is  extensive exposure to Hg in fish, the consumption of which may promote detrimental impacts on hematology parameters within the community.

Global Burden of Disease of Mercury Used in Artisanal Small-Scale Gold Mining

BACKGROUND

Artisanal small-scale gold mining (ASGM) is the world's largest anthropogenic source of mercury emission. Gold miners are highly exposed to metallic mercury and suffer occupational mercury intoxication. The global disease burden as a result of this exposure is largely unknown because the informal character of ASGM restricts the availability of reliable data.

OBJECTIVE

To estimate the prevalence of occupational mercury intoxication and the disability-adjusted life years (DALYs) attributable to chronic metallic mercury vapor intoxication (CMMVI) among ASGM gold miners globally and in selected countries.

METHODS

Estimates of the number of artisanal small-scale gold (ASG) miners were extracted from reviews supplemented by a literature search. Prevalence of moderate CMMVI among miners was determined by compiling a dataset of available studies that assessed frequency of intoxication in gold miners using a standardized diagnostic tool and biomonitoring data on mercury in urine. Severe cases of CMMVI were not included because it was assumed that these persons can no longer be employed as miners. Cases in workers' families and communities were not considered. Years lived with disability as a result of CMMVI among ASG miners were quantified by multiplying the number of prevalent cases of CMMVI by the appropriate disability weight. No deaths are expected to result from CMMVI and therefore years of life lost were not calculated. Disease burden was calculated by multiplying the prevalence rate with the number of miners for each country and the disability weight. Sensitivity analyses were performed using different assumptions on the number of miners and the intoxication prevalence rate.

FINDINGS

Globally, 14-19 million workers are employed as ASG miners. Based on human biomonitoring data, between 25% and 33% of these miners-3.3-6.5 million miners globally-suffer from moderate CMMVI. The resulting global burden of disease is estimated to range from 1.22 (uncertainty interval [UI] 0.87-1.61) to 2.39 (UI 1.69-3.14) million DALYs.

CONCLUSIONS

This study presents the first global and country-based estimates of disease burden caused by mercury intoxication in ASGM. Data availability and quality limit the results, and the total disease burden is likely undercounted. Despite these limitations, the data clearly indicate that mercury intoxication in ASG miners is a major, largely neglected global health problem.

Evidence of transboundary mercury and other pollutants in the Puyango-Tumbes River basin, Ecuador-Peru

In Portovelo in southern Ecuador, 87 gold processing centers along the Puyango-Tumbes River produce an estimated 6 tonnes of gold per annum using a combination of mercury amalgamation and/or cyanidation and processing poly-metallic ores. We analysed total Hg, Hg isotopes, total arsenic, cadmium, copper, lead and zinc in water and sediment along the Puyango in 2012-2014. The highest total mercury (THg) concentrations in sediments were found within a 40 km stretch downriver from the processing plants, with levels varying between 0.78-30.8 mg kg-1 during the dry season and 1.80-70.7 mg kg-1 during the wet season, with most concentrations above the CCME (Canadian Council of Ministers of the Environment) Probable Effect Level (PEL) of 0.5 mg kg-1. Data from mercury isotopic analyses support the conclusion that mercury use during gold processing in Portovelo is the source of Hg pollution found downstream in the Tumbes Delta in Peru, 160 km away. The majority of the water and sediment samples collected from the Puyango-Tumbes River had elevated concentrations of, arsenic, cadmium, copper, lead and zinc exceeding the CCME thresholds for the Protection of Aquatic Life. At monitoring points immediately below the processing plants, total dissolved concentrations of these metals exceeded the thresholds by 156-3567 times in surface waters and by 19-740 times in sediment. The results illustrate a significant transboundary pollution problem involving Hg and other toxic metals, amplified by the fact that the Puyango-Tumbes River is the only available water source in the semi-arid region of northern Peru.

Proof of concept for a passive sampler for monitoring of gaseous elemental mercury in artisanal gold mining

Mercury emissions from artisanal gold mining operations occurring in roughly 80 developing countries are a major workplace health hazard for millions of people as well as the largest contributor to global mercury pollution. There are no portable, cheap, and rapid methods able to inform workers or health practitioners of mercury exposure on site in remote locations. In this work, a proof of concept for a miniaturized mercury sampler, prepared by the direct reduction of gold into the porous nanostructures of Vycor glass (PVG), is introduced. Mercury retention on the PVG/Au sampler induces significant color changes, due to the formation of Au-Hg amalgam that affects the surface plasmon resonance characteristics of the material. The color change can potentially be quantified by the analysis of pictures obtained with a cell phone camera rapidly and onsite. Laboratory experiments showed the viability of using PVG/Au as passive sampler for monitoring of Hg°. PVG/Au samplers were then deployed in an artisanal and small-scale gold mining (ASGM) operations in Burkina Faso and it was able to indicate personal mercury exposures. The amount of mercury quantified in the samplers for all miners was higher than the current personal exposure limit set by the US Occupational Safety & Health Administration (OSHA).

Gold Mining in Ecuador: A Cross-Sectional Assessment of Mercury in Urine and Medical Symptoms in Miners from Portovelo/Zaruma

Mercury is a toxic metal and is used in small scale gold mining. In Portovelo, Ecuador, mercury has been an environmental and health problem for decades. The target of this study was to assess the mercury concentration in the urine of miners from Portovelo/Zaruma to establish a prevalence of high values. Eight hundred and sixty-five (865) urine samples were collected and analysed for their mercury content, using cold vapor atom absorption spectroscopy. The prevalence of high mercury values (>25 μg/L) was estimated. Forty-four (44) miners with mercury levels >15 μg/L filled in a questionnaire for characteristics and possible confounders, and were examined for intoxication symptoms to establish the ten points medical score sum. The median urine value was 1.8 μg/L; 78.3% of miners were below 7 μg/L and were not at risk of an intoxication, whereas 5.9% of miners exceeded the limit of 25 μg/L and were probable to experience intoxication symptoms. The medical score sum had a range of 2 to 8 points with a median of 6. The low prevalence of high mercury concentrations shows that the politics and techniques to eliminate the use of mercury are being successfully implemented. Further studies are needed to identify factors enabling this process.

Essential Indicators Identifying Chronic Inorganic Mercury Intoxication: Pooled Analysis across Multiple Cross-Sectional Studies

Background

The continuous exposure to inorganic mercury vapour in artisanal small-scale gold mining (ASGM) areas leads to chronic health problems. It is therefore essential to have a quick, but reliable risk assessing tool to diagnose chronic inorganic mercury intoxication. This study re-evaluates the state-of-the-art toolkit to diagnose chronic inorganic mercury intoxication by analysing data from multiple pooled cross-sectional studies. The primary research question aims to reduce the currently used set of indicators without affecting essentially the capability to diagnose chronic inorganic mercury intoxication. In addition, a sensitivity analysis is performed on established biomonitoring exposure limits for mercury in blood, hair, urine and urine adjusted by creatinine, where the biomonitoring exposure limits are compared to thresholds most associated with chronic inorganic mercury intoxication in artisanal small-scale gold mining.

Methods

Health data from miners and community members in Indonesia, Tanzania and Zimbabwe were obtained as part of the Global Mercury Project and pooled into one dataset together with their biomarkers mercury in urine, blood and hair. The individual prognostic impact of the indicators on the diagnosis of mercury intoxication is quantified using logistic regression models. The selection is performed by a stepwise forward/backward selection. Different models are compared based on the Bayesian information criterion (BIC) and Cohen`s kappa is used to evaluate the level of agreement between the diagnosis of mercury intoxication based on the currently used set of indicators and the result based on our reduced set of indicators. The sensitivity analysis of biomarker exposure limits of mercury is based on a sequence of chi square tests.

Results

The variable selection in logistic regression reduced the number of medical indicators from thirteen to ten in addition to the biomarkers. The estimated level of agreement using ten of thirteen medical indicators and all four biomarkers to diagnose chronic inorganic mercury intoxication yields a Cohen`s Kappa of 0.87. While in an additional stepwise selection the biomarker blood was not selected, the level of agreement based on ten medical indicators and only the three biomarkers urine, urine/creatinine and hair reduced Cohen`s Kappa to 0.46. The optimal cut-point for the biomarkers blood, hair, urine and urine/creatinine were estimated at 11. 6 μg/l, 3.84 μg/g, 24.4 μg/l and 4.26 μg/g, respectively.

Conclusion

The results show that a reduction down to only ten indicators still allows a reliable diagnosis of chronic inorganic mercury intoxication. This reduction of indicators will simplify health assessments in artisanal small-scale gold mining areas.

Mercury exposure and health impacts among individuals in the artisanal and small-scale gold mining community: a comprehensive review

BACKGROUND

Mercury (Hg) is used in gold mining to extract gold from ore by forming "amalgam"-a mixture composed of approximately equal parts mercury and gold. Approximately 15 million people, including approximately 3 million women and children, participate in artisanal small-scale gold mining (ASGM) in developing countries. Thirty-seven percent of global air emissions of Hg are produced by ASGM. The recently adopted Minamata Convention calls for nations to gather health data, train health-care workers, and raise awareness in regard to ASGM activity.

OBJECTIVE

The purpose of our review was to evaluate the current literature regarding the health effects of Hg among those working and/or living in or near ASGM communities.

METHODS

We searched PubMed, ScienceDirect, and Google Scholar for studies relating to health effects and biomarkers of Hg exposure in ASGM communities. Articles published from 1990 through December 2012 were evaluated for relevance.

DISCUSSION

Studies reporting health assessments, kidney dysfunction, neurological disorders and symptoms, and immunotoxicity/autoimmune dysfunction in individuals living in or near an ASGM community were identified. More than 60 studies that measured biomarkers of Hg exposure in individuals living in or near ASGM communities were also identified. These studies, conducted in 19 different countries in South America, Asia, and Africa, demonstrated that hair and urine concentrations are well above World Health Organization health guidance values in ASGM communities.

CONCLUSIONS

ASGM workers and their families are exposed to Hg vapor, and workers, workers' families, and residents of nearby and downstream communities are consuming fish heavily contaminated with methylmercury.

Emergence of delayed behavioral effects in offspring mice exposed to low levels of mercury vapor during the lactation period

This study examined the emergence of delayed behavioral effects in offspring mice exposed to low levels of mercury vapor (Hg(0)) during the lactation period. Female offspring of mice were repeatedly exposed to Hg(0) at 0.057 mg/m(3), similar to the current threshold value (TLV), for 24 hr until the 20(th) day postpartum. The behavioral effects were evaluated with locomotor activity in the open field (OPF), learning activity in the passive avoidance response (PA) and spatial learning ability in the Morris water maze (MM) at the ages of 3 and 15 months. Hg(0)-exposed mice did not differ from controls in the three behavioral measurements at 3 months of age, and no neurobehavioral effects were observed. On the other hand, the mice exhibited significantly more central locomotion in the OPF task when tested at 15 months of age, but no abnormality in other behavioral performance. Immediately after postnatal exposure, the brain mercury concentration of offspring was about 150 times that of the control, in which the concentrations were approximately 0.4 µg/g. The results indicate that mice exposed to Hg(0) at concentrations around TLV during the developing period resulted in the emergence of delayed behavioral effects at a later stage in life.

Mercury Exposures in Informal Gold Miners and Relatives in Southern Peru

Subjects working in or living near informal gold mining and processing in southern Peru were studied to determine mercury exposures from two tasks: amalgamation and amalgam smelting. The authors collected 17 airborne and 41 urinary mercury levels. The mean urinary levels were 728 (range: 321-1662) and 113 (45-197) microg/L for working in smelters and living near smelters, respectively. A third group working in amalgamation had a mean 18 microg/L (range 8-37). People living in the mining town but with no mining activities had 8 microg/L (5-10), while a control group outside the town had 4 microg/L (2-6). Mean airborne mercury exposure was 2423 microg/m3 (range 530-4430) during smelting, 30.5 microg/m3 (12-55) during amalgamation, and 12 microg/m3 (3-23) in the mining town. Smelters are highly contaminated with mercury, as are the people living around smelters.

Mercury Reduction in Munhena, Mozambique: Homemade Solutions and the Social Context for Change

The health and environmental impacts of artisanal gold mining are of growing concern in Munhena, Mozambique, where more than 12,000 people are involved in such activities. Gold is extracted using mercury amalgamation, posing a considerable threat to human and environmental health. A pilot project ascertained the feasibility of reducing mercury use and emissions by promoting control measures utilizing local resources. Retorts were fabricated with local materials. Training workshops introduced the homemade retorts, and a portable mercury monitor revealed effective mercury reduction. Barriers to widespread technology adoption include poverty, lack of knowledge and trust, and the free supply of mercury from private gold buyers. Homemade retorts are inexpensive and effective, and miners could benefit by building community amalgamation centers. The government could play a greater role in gold purchasing to reduce mercury pollution.

Mercury exposure among artisanal gold miners in Madre de Dios, Peru: a cross-sectional study

INTRODUCTION

Exposure to mercury, a toxic metal, occurs primarily from inhaling mercury vapors or consuming methylmercury-contaminated fish. One third of all anthropogenic mercury emissions worldwide are from artisanal gold mining, which uses mercury to extract gold. Although recent reports suggest that the Madre de Dios region in Peru (with >30,000 artisanal miners) has extensive mercury contamination, residents had never been assessed for mercury exposure. Thus, our objective was to quantify mercury exposure among residents of an artisanal mining town in Madre de Dios and to assess risk factors for exposure.

METHODS

We conducted a cross-sectional assessment of 103 residents of an artisanal gold mining town in July 2010. Each participant provided a urine and blood sample and completed a questionnaire assessing potential exposures and health outcomes. We calculated geometric mean (GM) urine total mercury and blood methylmercury concentrations and compared log-transformed concentrations between subgroups using linear regression.

RESULTS

One third (34.0 %) of participants were gold miners. All participants had detectable urine total mercury (GM, 5.5 μg/g creatinine; range, 0.7-151 μg/g creatinine) and 91 % had detectable blood methylmercury (GM, 2.7 μg/L; range, 0.6-10 μg/L); 13 participants (13 %) reported having kidney dysfunction or a neurological disorder. Urine total mercury concentrations were higher among people who heated gold-mercury amalgams compared with people who never heated amalgams (p < 0.05); methylmercury concentrations were higher among fish consumers compared with nonfish consumers (p < 0.05).

CONCLUSION

Our findings suggest that mercury exposure may be widespread in Huaypetue.

Role of methylmercury exposure (from fish consumption) on growth and neurodevelopment of children under 5 years of age living in a transitioning (tin-mining) area of the western Amazon, Brazil

Human occupation of the Amazon region has recently increased, bringing deforestation for agriculture and open-cast mining, activities that cause environmental degradation and pollution. Families of new settlers in mining areas might have a diet less dependent on abundant fish and their children might also be impacted by exposures to mining environments. Therefore, there is compounded interest in assessing young children's nutritional status and neurobehavioral development with regard to family fish consumption. Anthropometric (z-scores, WHO standards) and neurologic [Gesell developmental scores (GDS)] development in 688 preschool children (1-59 months of age) was studied. Overall, the prevalence of malnutrition [i.e., moderate stunting (≤2 H/A-Z), underweight (≤2 W/A-Z), and wasting (≤2 W/H-Z) were respectively 0.3% (n = 2), 1.6% (n = 11), and 2.5% (n = 17). Children's mean hair Hg (HHg) concentration was 2.56 μg/g (SD = 1.67); only 14% of children had HHg concentrations lower than 1 μg/g and 1.7% had ≥5 μg/g. The biomarker of fish consumption was weakly but positively correlated with GDS (Spearman r = 0.080; p = 0.035). In the bivariate model, attained W/H-Z scores were not significantly correlated with GDS. A moderate level of GDS deficits (70-84%) was seen in 20% of children. There was significant correlation between family fish consumption and children's hair Hg (HHg) (Spearman r = 0.1756; p < 0.0001) but no significant correlation between children's HHg and W/H-Z scores. However, the multivariate model showed that breastfeeding, a fish consumption biomarker (HHg), maternal education, and child's age were statistically significant associated with specific domains (language and personal-social) of the Gesell scale. In this mining environment, family fish-eating did not affect children's linear growth, but it showed a positive influence (along with maternal variables) on neurodevelopment. Health hazards attendant on a high prevalence of moderate neurodevelopment delays coexisting with exposure to multiple neurotoxic substances merits further investigation in poor environmental settings of tin-mining areas.

Acoustic stapedius muscle reflex in mercury-exposed Andean children and adults

CONCLUSION

The results suggested mercury (Hg)-induced anomalies in the brainstem-mediated acoustic stapedius muscle reflex in children.

OBJECTIVES

Hg exposure has been associated with hearing impairment and brainstem anomalies. Acoustic stapedius reflex (ASR) thresholds, growth functions, decay/adaptation times, and behavioral auditory thresholds were used to screen Andean children and adults for Hg-induced auditory brainstem and facial nerve impairment.

METHODS

Fifty-one participants, which included 22 children (aged 6-17 years) and 29 adults (aged 19-83 years) living in gold mining areas of Ecuador where Hg is widely used in amalgamation, were screened using ASR immittance procedures.

RESULTS

Mean blood mercury (HgB) level in the children was 15.6 μg/L (SD, 21.3; median, 7 μg/L; range, 2.0-89 μg/L), and in the adults 8.5 μg/L (SD, 7.1; median, 6 μg/L; range, 2.0-32 μg/L). Mean contralateral ASR thresholds (ASRT) for the screening frequency of 2000 Hz in the children (39 ears) was 92.9 dB HL (SD, 6.1; range, 80-105 dB HL), and in the adults (53 ears) 90.0 dB HL (SD, 6.4; range, 65-105 dB HL). The ASRT in the children increased significantly with HgB level (rho = 0.433; p = 0.008).

Relationship between localization of gold mining areas and hair mercury levels in people from Bolivar, north of Colombia

Mercury (Hg) is a heavy metal that, once in the environment, is bioaccumulated and biomagnified through food chain impacting ecosystems. The aim of this study was to evaluate total Hg (T-Hg) concentrations in individuals along Cauca and Magdalena Rivers in Colombia, where most gold mining activities take place. A total of 1,328 hair samples were collected and analyzed for T-Hg using atomic absorption spectroscopy. T-Hg concentrations ranged from 0.01 to 20.14 μg/g. Greatest levels were detected in La Raya (5.27 ± 0.32 μg/g), Achi (2.44 ± 0.22 μg/g), and Montecristo (2.20 ± 0.20 μg/g), places that are located near gold mines. Concentrations decreased with the distance from main mining areas. Only 0.75% of the individuals had T-Hg levels above 10 μg/g. Men had significantly higher T-Hg levels than women, and correlation analysis revealed moderately weak but significant relationships between T-Hg and weight (R = 0.111, P < 0.001), stature (R = 0.111, P < 0.001), and age (R = 0.073, P = 0.007). However, T-Hg concentrations did not vary according to fish consumption frequency. Subjective health survey showed no Hg-related signs or symptoms within studied sample. However, studies are necessary to detect neurological damage linked to the metal. Changing technologies to Hg-free mining, monitoring, and educational programs are necessary to protect health of people living near Colombian rivers.

Hair can be a good biomarker of occupational exposure to mercury vapor: simulated experiments and field data analysis

Generally, urine mercury (U-Hg) is widely used for assessment of inorganic mercury (I-Hg) exposure in humans. The reliability of scalp hair as an indicator of mercury vapor exposure is contentious. However, significant correlations were found between hair total mercury (T-Hg) and U-Hg and between hair I-Hg and total gaseous mercury (TGM) in ambient air in our previous studies. Simulated experiments were designed to assess the contribution of direct absorption/adsorption of mercury vapor in the hair. Results indicated that the increases of hair T-Hg concentrations were less than 1 μg/g, which was negligible compared with hair T-Hg concentrations in occupationally exposed workers. The β-mercaptoethanol washing can remove 30% of mercury (Hg) in the exposed hair samples. The inhaled Hg constituted the major fraction (97.4%) of I-Hg exposure for the artisanal Hg mining workers. From the simulated experiments and field data analysis, we can conclude that hair I-Hg can be a useful tool for monitoring occupational exposure to Hg vapor.

Hair mercury levels in pregnant women in Mahshahr, Iran: fish consumption as a determinant of exposure

MeHg is a well-documented neurotoxicant even at low levels of exposure. Developing brain, in particular, is vulnerable to that. Through bioaccumulating to differing degrees in various fish species, it can have serious adverse effects on the development and functioning of the human central nervous system, especially during prenatal exposure. Therefore, the purpose of this study was to investigate mercury concentration in hair samples of pregnant women living in Mahshahr located in Khuzestan province, Iran. It assessed the association between fish consumption and specific characteristics that can influence exposure. From April to June 2008, 149 pregnant women were invited to participate in this study. An interview administered questionnaire was used to collect information about age, body weight, height, fish (fresh, canned and shrimp) consumption, pregnancy stage, residence duration, education level, family income and number of dental amalgam fillings. The obtained results showed that the geometric mean and range for hair total Hg concentration was 3.52 microg/g (0.44-53.56 microg/g). About 5.4% of mothers had hair total Hg levels in excess of 10 microg/g. Maternal hair mercury level was less than threshold level of WHO (5 microg/g). As expected, there was a clear increase in hair Hg with reported fresh marine fish consumption (p=0.04). The highest mean for hair mercury level in a group who consumed fish several times per week, was 4.93 microg/g. Moreover, a significant effect of age and residential time on Hg concentration in the hair of the women was found. Pregnant women in Mahshahr consumed large amounts of fish; consequently, most of their offspring were prenatally exposed to moderately high levels of mercury. The results found suggest that pregnant women should decrease their fish consumption.

Mercury exposure and children's health

Acute or chronic mercury exposure can cause adverse effects during any period of development. Mercury is a highly toxic element; there is no known safe level of exposure. Ideally, neither children nor adults should have any mercury in their bodies because it provides no physiological benefit. Prenatal and postnatal mercury exposures occur frequently in many different ways. Pediatricians, nurses, and other health care providers should understand the scope of mercury exposures and health problems among children and be prepared to handle mercury exposures in medical practice. Prevention is the key to reducing mercury poisoning. Mercury exists in different chemical forms: elemental (or metallic), inorganic, and organic (methylmercury and ethyl mercury). Mercury exposure can cause acute and chronic intoxication at low levels of exposure. Mercury is neuro-, nephro-, and immunotoxic. The development of the child in utero and early in life is at particular risk. Mercury is ubiquitous and persistent. Mercury is a global pollutant, bio-accumulating, mainly through the aquatic food chain, resulting in a serious health hazard for children. This article provides an extensive review of mercury exposure and children's health.

Hair mercury levels in Amazonian populations: spatial distribution and trends

BACKGROUND

Mercury is present in the Amazonian aquatic environments from both natural and anthropogenic sources. As a consequence, many riverside populations are exposed to methylmercury, a highly toxic organic form of mercury, because of their intense fish consumption. Many studies have analysed this exposure from different approaches since the early nineties. This review aims to systematize the information in spatial distribution, comparing hair mercury levels by studied population and Amazonian river basin, looking for exposure trends.

METHODS

The reviewed papers were selected from scientific databases and online libraries. We included studies with a direct measure of hair mercury concentrations in a sample size larger than 10 people, without considering the objectives, approach of the study or mercury speciation. The results are presented in tables and maps by river basin, displaying hair mercury levels and specifying the studied population and health impact, if any.

RESULTS

The majority of the studies have been carried out in communities from the central Amazonian regions, particularly on the Tapajós River basin. The results seem quite variable; hair mercury means range from 1.1 to 34.2 microg/g. Most studies did not show any significant difference in hair mercury levels by gender or age. Overall, authors emphasized fish consumption frequency as the main risk factor of exposure. The most studied adverse health effect is by far the neurological performance, especially motricity. However, it is not possible to conclude on the relation between hair mercury levels and health impact in the Amazonian situation because of the relatively small number of studies.

CONCLUSIONS

Hair mercury levels in the Amazonian regions seem to be very heterogenic, depending on several factors. There is no obvious spatial trend and there are many areas that have never been studied. Taking into account the low mercury levels currently handled as acceptable, the majority of the Amazonian populations can be considered exposed to methylmercury contamination. The situation for many of these traditional communities is very complex because of their high dependence on fish nutrients. It remains difficult to conclude on the Public Health implication of mercury exposure in this context.

Human mercury exposure and adverse health effects in the Amazon: a review

This paper examines issues of human mercury (Hg) exposure and adverse health effects throughout the Amazon region. An extensive review was conducted using bibliographic indexes as well as secondary sources. There are several sources of Hg (mining, deforestation, reservoirs), and exposure takes place through inhalation or from fish consumption. There is a wide range of exposure, with mean hair-Hg levels above 15 microg/g in several Amazonian communities, placing them among the highest reported levels in the world today. Dietary Hg intake has been estimated in the vicinity of 1-2 microg/kg/day, considerably higher than the USEPA RfD of 0.1 microg/kg/day or the World Health Organization recommendation of 0.23 microg/kg/day. Neurobehavioral deficits and, in some cases, clinical signs have been reported both for adults and children in relation to Hg exposure in several Amazonian countries. There is also some evidence of cytogenetic damage, immune alterations, and cardiovascular toxicity. Since fish provide a highly nutritious food source, there is an urgent need to find realistic and feasible solutions that will reduce exposure and toxic risk, while maintaining healthy traditional dietary habits and preserving this unique biodiversity.

Scalp hair as a biomarker in environmental and occupational mercury exposed populations: suitable or not?

Hair is a well-established and widely used matrix for measuring mercury exposure of an individual. Although a variety of washing procedures to remove external mercury contamination have been proposed, no standardized procedures are available yet. In this study, different washing reagents like l-cysteine (Cys), 2-mercaptoethanol (ME), and disodium diaminoethanetetra acetate (EDTA) were used to find out if it is possible to remove mercury contamination from human scalp hair spiked with HgCl2 solutions at different concentrations. It was found that the external mercury contamination could not be fully washed off even using reagents with high affinity to mercury like l-cysteine and ME. However, for the well-pulverized CRM hair samples some of the endogenous mercury was washed off. It suggests that hair is not a suitable biomarker for evaluation of total mercury exposure especially in people like mercury miners or gold miners/burners associated with serious external Hg exposure. However, hair still can be used as an indicator for methyl mercury exposure because, generally, there is almost no exogenous contamination of methyl mercury in hair.

Methylmercury exposure and health effects in humans: a worldwide concern

The paper builds on existing literature, highlighting current understanding and identifying unresolved issues about MeHg exposure, health effects, and risk assessment, and concludes with a consensus statement. Methylmercury is a potent toxin, bioaccumulated and concentrated through the aquatic food chain, placing at risk people, throughout the globe and across the socioeconomic spectrum, who consume predatory fish or for whom fish is a dietary mainstay. Methylmercury developmental neurotoxicity has constituted the basis for risk assessments and public health policies. Despite gaps in our knowledge on new bioindicators of exposure, factors that influence MeHg uptake and toxicity, toxicokinetics, neurologic and cardiovascular effects in adult populations, and the nutritional benefits and risks from the large number of marine and freshwater fish and fish-eating species, the panel concluded that to preserve human health, all efforts need to be made to reduce and eliminate sources of exposure.

Children's environment and health in Latin America: the Ecuadorian case

Environmental health problems of children in Latin America and Ecuador are complex due to the close relationship that exists between social and environmental factors. Extended poverty and basic problems, such as the lack of drinking water and sanitation, are common. Infectious diseases are the greatest cause of morbidity and mortality among children. Development in industry and the introduction of chemical substances in agriculture add new risks including pesticide use, heavy metal exposure, and air pollution. Major problems can be divided into (a) lack of basic infrastructure, (b) poor living conditions, (c) specific environmental problems, and (d) child labor. Reproductive health disorders are frequent in developing countries like Ecuador. Issues related to children's health should consider new approaches, creative methodologies, and the search for independent predictors to separate environmental from social problems. Only with knowledge of the specific contribution of each factor, can it be possible to develop a strategy for prevention.

Neurocognitive screening of mercury-exposed children of Andean gold miners

Performance on Raven's Coloured Progressive Matrices (RCPM) test of visual-spatial reasoning was used to evaluate the effects of mercury (Hg) exposure on 73 Andean children aged 5 to 11 years (mean: 8.4) living in the Nambija and Portovelo gold mining areas of Ecuador, where Hg is widely used in amalgamation. Mean levels of Hg found in blood (Hg(B)), urine (Hg(U)), and hair (Hg(H)) samples were 5.1 microg/L (SD: 2.4; range: 1-10 microg/L), 13.3 microg/L (SD: 25.9; range: 1-166 microg/L), and 8.5 microg/g (SD: 22.8; range: 1-135 microg/g), respectively. Of the children in the Nambija area 67-84.9% had abnormal RCPM standard scores (i.e., < or = 25%tile), depending on the test norm used in the data analysis. Higher standard scores for Peruvian (t = 4.77; p = < 0.0001) and Puerto Rican (t = 4.51; p = < 0.0001) norms than for U.S. norms suggested a linguistic influence. No difference was found between Peruvian and Puerto Rican norms (t = 0.832; p = < 0.408), which showed a significant positive correlation (r = 0.915, p = < 0.0001). Children with abnormal Hg(B) and Hg(H) levels had significantly lower scores on the RCPM subtest B than did children with nontoxic Hg levels (t = -2.16; p = < 0.034). These results suggest that a substantial number of Hg-exposed children in the Nambija study area have neurocognitive deficits in visual-spatial reasoning.