Organochlorines, lead, and mercury in Akwesasne Mohawk youth

An evidence map of polychlorinated biphenyl exposure and health outcome studies among residents of the Akwesasne Mohawk Nation

From the 1950s to the 1970s, three Superfund sites discharged polychlorinated biphenyl (PCB)-contaminated waste upstream of the Mohawk Nation at Akwesasne, resulting in PCB contamination of groundwater, soil, and sediment in the surrounding area. Given the persistence of PCBs in the environment and in human tissues, there are continued concerns regarding PCB exposures and the potential for adverse health effects in the community. We developed an evidence map of PCB research at Akwesasne in order to characterize the available data and to highlight potential research needs. Human health and exposure biomarker studies were identified from a literature search based on population, exposure, comparator, and outcome (PECO) criteria. Data extracted from references that met the inclusion criteria after full-text review included study characteristics (e.g., sample size, study design, sampling years), details on PCB measurements (e.g., analytical method, number of congeners analyzed, method detection limits), and results (e.g., PCB levels and summary of study conclusions). We identified 33 studies, conducted between 1986 and 2013, that examined PCB exposure characteristics and health effects in residents of the Akwesasne Mohawk Nation. Organizing this literature into an evidence map including information on study cohort, congener groupings, exposure biomarker characteristics, and health effects allowed us to identify research gaps and to suggest future research priorities for the community. We identified current PCB exposure levels and PCB source characterization as major uncertainties, both of which could be addressed by new studies of PCB concentrations in environmental media.

Impact of modernization on urinary concentrations of arsenic, cadmium, lead, and selenium in rural residents of Northern Laos

OBJECTIVES

The impacts of modernization on toxic heavy metal exposure and essential trace element intake in indigenous populations of subsistence societies are unknown. We assessed urinary trace element concentrations in rural residents of Northern Laos and examined associations with levels of modernization.

METHODS

A cross-sectional study was conducted comprising 380 residents of three villages in Northern Laos with different levels of modernization. We surveyed general characteristics and measured the weight and height of 341 participants. Arsenic, cadmium, lead, and selenium concentrations were measured in spot urine samples by inductively coupled plasma mass spectrometry. We examined associations between urinary trace element concentrations and variables related to modernization (village, roofing material, possessions index [total number of possessions], and body mass index [BMI]) using multilevel analyses with household as a random effect, after adjusting for sex, age, and smoking status.

RESULTS

Urinary concentrations of arsenic and cadmium were high, while those of lead and selenium were low in comparison to previous reports of populations in non-contaminated regions or without excess/deficiency. We observed associations between urinary trace element concentrations and village-level modernization: lead and selenium concentrations were higher in more modernized villages and cadmium concentration was highest in the least modernized village. Urinary arsenic concentration was not predicted by the modernization level of a village, although we observed significant differences among villages. In addition, urinary selenium concentration was higher in participants inhabiting more modernized houses.

CONCLUSION

Modernization of villages may impact toxic heavy metal exposure and selenium intake in rural residents of Northern Laos.

Interactions among thyroid hormones and serum lipid levels in association with PCB exposure in the Mohawk Akwesasne population

Alterations in thyroid function and serum lipid levels were assessed in relation to exposure to polychlorinated biphenyls (PCBs) and three chlorinated pesticides (DDE, hexachorobenzene and mirex) in a sample of Akwesasne Mohawk adults. This population is highly exposed to PCBs because of living in close proximity to three aluminum foundries that used PCBs as hydraulic fluids, which then contaminated local fish, wildlife, water, air and soils. The goal was to assess interactions between thyroid function (TSH, T3, T4 and fT4) and serum lipids (cholesterol, triglycerides and total serum lipids) in relation to concentrations of 101 PCB congeners and three chlorinated pesticides. Previous studies in this population have shown that elevated concentrations of PCBs resulted in suppression of thyroid function in adolescents, and increased risk of clinical hypothyroidism in adults, as well as an elevation in serum lipids. However in adjusted analyses of PCB concentrations of 703 adults we find only small and inconsistent associations between serum PCB levels and thyroid function. The most striking observations were strong significant positive associations between TSH and T3 with serum lipids and a negative association with fT4 in women. Because elevated serum lipids increase risks of other diseases the respective roles of thyroid hormones and PCBs in regulation of serum lipids requires additional study.

Modern water: A biocultural approach to water pollution at the Akwesasne Mohawk Nation

OBJECTIVES

The goal of this article is to review a body of research around water contamination conducted in the Akwesasne Mohawk Nation between 1995 and 2016, place these findings in a biocultural context, and consider implications for a human biology of water.

METHODS

This review draws on research projects conducted in partnership with the Akwesasne Mohawk Nation living along the St. Lawrence River as well as published research by others on water contamination at Akwesasne. Quantitative and qualitative methods including toxicological and epidemiological methods, surveys, and ethnographic studies are included.

RESULTS

Pollution of a river with polychlorinated biphenyls (PCBs) contaminated local fish, a major, traditional, food source. Following health advisories to avoid consuming local fish, consumption and PCB levels decreased. PCB levels were negatively associated with health outcomes. In adolescents, higher PCB levels were associated with advanced sexual maturation in females, reduced testosterone in males and reduced thyroxine levels in young adults. Avoiding fish consumption altered traditional dietary patterns and social interactions, generational transmission of knowledge, and relations between generations, all of which impacted cultural forms and may have added to the perceived injustices in this Native American community. Items substituted for fish may have contributed to increasing rates of obesity as well.

CONCLUSIONS

Water pollution has immediate direct health consequences as well as cultural impacts related to changed food consumption and altered patterns of social interaction.

Trends in height, weight, BMI, skinfolds, and measures of overweight and obesity from 1979 through 1999 among American Indian Youth: The Akwesasne Mohawk

BACKGROUND/OBJECTIVES

Information on recent changes in overweight, obesity, and adiposity among American Indians is scarce. To assess changes in size and adiposity among American Indian youth, data from two samples of Akwesasne Mohawk youth, were compared.

SUBJECTS/METHODS

Both project 1, conducted in 1979 (n = 75) and Project 2, conducted between 1996 and 1999 (n = 206), sampled youth 10-14 years of age from the Akwesasne Mohawk Reservation (aka St. Regis) that borders New York state, and Ontario and Quebec provinces. Heights, weights, and skinfold thicknesses were converted to z-scores using CDC reference values. BMI status was calculated in terms of WHO age-specific cutoffs and CDC cutoffs.

RESULTS

z-Scores for heights differed little between projects. The between-project difference in weight z-score is twice the between-project z-score difference for height. Differences among males are larger and more often significant. Triceps and subscapular skinfold thickness are significantly greater in Project 2. The rate of overweight and obesity combined, increased 3.3-fold. In multiple regression analyses with sex, height, and age in the model, project is a significant predictor of weight and skinfolds.

CONCLUSIONS

Weight and adiposity have increased substantially from 1979 to 1996-99. Overweight and obesity became significantly more common. Given the increase in adiposity, these youth may be facing significant health risks as adults in terms of cardiovascular disease, cancer, and type II diabetes unless weight and adiposity is reduced.

Review of built and natural environment stressors impacting American-Indian/Alaska-Native children

Children's exposures to chemical and non-chemical stressors from their everyday environment affects their overall health and well-being. American-Indian/Alaska-Native (AI/AN) children may have a disproportionate burden of stressors from their built and natural environments when compared to children from other races/ethnicities. Our objectives were to identify chemical and non-chemical stressors from AI/AN children's built and natural environments and evaluate their linkages with health and well-being outcomes from the peer reviewed literature. Library databases (e.g. PubMed) were searched to identify studies focused on these stressors. References were excluded if they: did not discuss AI/AN children or they were not the primary cohort; discussed tribes outside the United States (U.S.); were reviews or intervention studies; or did not discuss stressors from the built/natural environments. Out of 2539 references, 35 remained. Sample populations were predominantly (70%) in New York (NY) and Alaska (AK); 14 studies reported on the same cohort. Studies with matching stressors and outcomes were few, ruling out a quantitative review. Respiratory and developmental outcomes were the main outcomes evaluated. Primary non-chemical stressors were residential proximity to polluted landscapes, lack of indoor plumbing, and indoor use of wood for heating or cooking. The main chemical stressors were volatile organic compounds (VOCs), particulate matter (PM2.5), polychlorinated biphenyls (PCBs), p,p'-DDE, hexachlorobenzene (HCB), lead, and mercury. Our qualitative review was suggestive of a potential increase in respiratory illness from indoor wood use or no plumbing, which can be used as a guide to promote healthy environments for AI/AN children. We identified limited studies (<40), demonstrating this population as understudied. Future studies need to consider: sample populations from other tribes in the U.S., stressors outside the household, other elements of the natural environment, and an evaluation of stressors from AI/AN children's total environment (built, natural, and social).

Patterns of PCB exposure among Akwesasne adolescents: The role of dietary and inhalation pathways

AIM

The objective of this study is to determine if consumption of fish and other dietary elements are related to the serum PCB levels of a group of adolescents. A dietary pattern approach is used to provide a more complete dietary exposure profile rather than a single food/group approach. Additionally, dietary patterns are examined in relation to traditional PCB groupings as well as derived PCB congener profiles.

PARTICIPANTS/SETTING AND METHODS

The sample is comprised of 246 Mohawk adolescents between the ages of 10-16.9 years of age residing at the Akwesasne Mohawk Nation. Food frequency data was collected and serum PCB levels were (101 congeners) quantitated during a cross-sectional study investigating adolescent exposure to environmental pollutants.

RESULTS

Principal component analysis identified four dietary patterns: "well-rounded" "snacks and sweets" "fruits and vegetables" "fish and dairy" and four PCB congener profiles: "1248-like", Persistent/"1260-like", "mono-ortho", and "1254-like". In a multiple regression models, the "fish and dairy" dietary or traditional PCB determinants (age, sex, prior breastfeeding, BMI, pattern) were each predictors of one or more of three of the identified PCB congener profiles. However, the "1248-like" pattern was not related to either dietary pattern or any of the typical PCB determinants, suggesting an alternative source/exposure pathway for this congener profile.

CONCLUSION

Even relatively low levels of fish consumption within the composite dietary matrix of adolescents at Akwesasne remains a pathway of exposure to postnatally acquired PCBs. In addition, there is evidence of an unidentified, perhaps airborne, exposure pathway that warrants further attention as this congener profile accounted for 50% of the total variance within the adolescents' serum PCB levels.

PCBs and measures of attention and impulsivity on a continuous performance task of young adults

The present study examines the relationship between current body burden of persistent PCBs and attention and impulsivity in 140 Akwesasne Mohawk young adults aged 17 to 21 whose environment has been contaminated by industrial effluent. Attention and impulsivity were measured by errors of omission, errors of commission, and patterns of reaction time responses on the Conners Continuous Performance Test. The PCB measure was the sum of those persistent PCB congeners detected in 50% of the participants. After adjusting for multiple covariates, regression analyses showed a significant positive relationship between PCB levels and omission scores, but only for males.

Power and pollutant exposure in the context of American Indian health and survival

BACKGROUND

American Indians and Alaskan Natives (AI/AN) are a highly diverse group in terms of culture and language, but share a history of oppression and attempted extermination that has left many with a legacy of poverty and poor health. Cultural and biological survival are important issues for many AI/AN groups.

METHODS

Using US criteria, AI/AN groups are more likely to be poor. The US National Center for Health Statistics reports that US AI/ANs have higher mortality and morbidity rates than the US population. While all groups racially defined by the US National Center for Health Statistics have been experiencing a decline in fertility since 1983, AI/ANs seem to be suffering a substantially greater and earlier decline in fertility. Given the importance of fertility in the survival of AI/AN communities, it is important to identify the source of this decline.

RESULTS

A recent study of one AI/AN group living along the St. Lawrence River found that obesity and exposure to a particular group of polychlorinated biphenyls were the factors most highly associated with indicators of impaired fertility. Economic factors are often cited as reasons for fertility declines, however in this situation these other factors may have either primary or contributing roles.

CONCLUSIONS

If the associations with obesity and toxicant exposure are confirmed, intervening on these factors might be important steps in stemming continued declines in fertility.

Changes in persistent organic pollutant levels from adolescence to young adulthood

Elimination rates and their corresponding half-lives are conceptually important and intuitively accessible pharmacokinetic measures of toxicant elimination, but regression-based estimates are biased proportional to the degree of continuing (background) exposure. We propose an alternative estimator, the censored normal regression model, which uses all observations, but treats individuals whose initial level failed to exceed their follow-up level as censored observations to weight the regression estimates from those that declined between blood draws. In this manner, we derive the intrinsic elimination rate, the elimination rate free from ongoing exposure, as a parameter in a regression with an unobserved, latent dependent variable. We utilize sequential measurements of persistent organic pollutants (POPs) levels from adolescence to adulthood, a period of intense change in size and body composition, to quantify individual-level change within a community exposed to significant quantities of contaminants over an extended period of time. Although much research has been conducted on effects of POPs, far less attention has been given to vectors of intake and changes in toxicant levels during the life course. We apply exploratory factor analysis (EFA) to types and timing of consumption, along with physical behavioral characteristics, to identify a structure of seven underlying factors. Although several variables show factorial complexity, the latent constructs included an age/maturation and period-related factor, a nutritional composite, consumption prior to pregnancy, fish and fowl consumed during pregnancy, factors distinguishing body mass and weight from height, and bottom-feeding fish consumption. Unadjusted and adjusted half-lives using the censored normal regression estimator, as well as estimated half-lives from conventional log concentration regressions, are reported for PCB groupings, specific congeners, p,p'-DDE, and HCB.

Relationships of polychlorinated biphenyls and dichlorodiphenyldichloroethylene (p,p'-DDE) with testosterone levels in adolescent males

BACKGROUND

Concern persists over endocrine-disrupting effects of persistent organic pollutants (POPs) on human growth and sexual maturation. Potential effects of toxicant exposures on testosterone levels during puberty are not well characterized.

OBJECTIVES

In this study we evaluated the relationship between toxicants [polychlorinated biphenyls (PCBs), dichlorodiphenyldichloroethylene (p,p´-DDE), hexachlorobenzene (HCB), and lead] and testosterone levels among 127 Akwesasne Mohawk males 10 to < 17 years of age with documented toxicant exposures.

METHODS

Data were collected between February 1996 and January 2000. Fasting blood specimens were collected before breakfast by trained Akwesasne Mohawk staff. Multivariable regression models were used to estimates associations between toxicants and serum testosterone, adjusted for other toxicants, Tanner stage, and potential confounders.

RESULTS

The sum of 16 PCB congeners (Σ16PCBs) that were detected in ≥ 50% of the population was significantly and negatively associated with serum testosterone levels, such that a 10% change in exposure was associated with a 5.6% decrease in testosterone (95% CI: -10.8, -0.5%). Of the 16 congeners, the more persistent ones (Σ8PerPCBs) were related to testosterone, whereas the less persistent ones, possibly reflecting more recent exposure, were not. When PCB congeners were subgrouped, the association was significant for the sum of eight more persistent PCBs (5.7% decrease; 95% CI: -11, -0.4%), and stronger than the sum of six less persistent congeners (3.1% decrease; 95% CI: -7.2, 0.9%). p,p´-DDE was positively but not significantly associated with serum testosterone (5.2% increase with a 10% increase in exposure; 95% CI: -0.5, 10.9%). Neither lead nor HCB was significantly associated with testosterone levels.

CONCLUSIONS

Exposure to PCBs, particularly the more highly persistent congeners, may negatively influence testosterone levels among adolescent males. The positive relationship between p,p´-DDE and testosterone indicates that not all POPs act similarly.

CITATION

Schell LM, Gallo MV, Deane GD, Nelder KR, DeCaprio AP, Jacobs A; Akwesasne Task Force on the Environment. 2014. Relationships of polychlorinated biphenyls and dichlorodiphenyldichloroethylene (p,p´-DDE) with testosterone levels in adolescent males. Environ Health Perspect 122:304-309; http://dx.doi.org/10.1289/ehp.1205984.

PCBs and ADHD in Mohawk adolescents

The present study examines the relationship between the levels of persistent polychlorinated biphenyls (PCBs) in adolescents' blood serum and concurrent measures of their ADHD-like behavior derived from ratings provided by parents and teachers. Two measures with demonstrated diagnostic validity, the Conners and ADDES scales, are used. The study was conducted in partnership with the Mohawk Nation at Akwesasne where the St. Lawrence River and surrounding waterways have been contaminated with PCBs that have entered the food chain. This study examines a subset of the data derived from the Mohawk Adolescent Well-Being Study (MAWBS), which was designed to investigate psychosocial and health related outcomes of 271 adolescents aged 10 years to 17 years and whose mothers were likely to have consumed PCB-contaminated fish and wild game before and during their pregnancy. No evidence of negative effects of adolescent blood PCB levels on ADHD-like behavior was found, and indeed occasional findings were in the unexpected direction. The possibility of negative confounding by SES and breastfeeding history was examined but dismissed.

PCB 136 atropselectively alters morphometric and functional parameters of neuronal connectivity in cultured rat hippocampal neurons via ryanodine receptor-dependent mechanisms

We recently demonstrated that polychlorinated biphenyl (PCB) congeners with multiple ortho chlorine substitutions sensitize ryanodine receptors (RyRs), and this activity promotes Ca²⁺-dependent dendritic growth in cultured neurons. Many ortho-substituted congeners display axial chirality, and we previously reported that the chiral congener PCB 136 (2,2',3,3',6,6'-hexachlorobiphenyl) atropselectively sensitizes RyRs. Here, we test the hypothesis that PCB 136 atropisomers differentially alter dendritic growth and other parameters of neuronal connectivity influenced by RyR activity. (-)-PCB 136, which potently sensitizes RyRs, enhances dendritic growth in primary cultures of rat hippocampal neurons, whereas (+)-PCB 136, which lacks RyR activity, has no effect on dendritic growth. The dendrite-promoting activity of (-)-PCB 136 is observed at concentrations ranging from 0.1 to 100 nM and is blocked by pharmacologic RyR antagonism. Neither atropisomer alters axonal growth or cell viability. Quantification of PCB 136 atropisomers in hippocampal cultures indicates that atropselective effects on dendritic growth are not due to differential partitioning of atropisomers into cultured cells. Imaging of hippocampal neurons loaded with Ca²⁺-sensitive dye demonstrates that (-)-PCB 136 but not (+)-PCB 136 increases the frequency of spontaneous Ca²⁺ oscillations. Similarly, (-)-PCB 136 but not (+)-PCB 136 increases the activity of hippocampal neurons plated on microelectrode arrays. These data support the hypothesis that atropselective effects on RyR activity translate into atropselective effects of PCB 136 atropisomers on neuronal connectivity, and suggest that the variable atropisomeric enrichment of chiral PCBs observed in the human population may be a significant determinant of individual susceptibility for adverse neurodevelopmental outcomes following PCB exposure.

Dietary patterns of Akwesasne Mohawk adolescents

BACKGROUND

Native American youth have greater rates of overweight/obesity than same-aged youth from the general population. Even though dietary shifts are suspected, surprisingly little information exists concerning the dietary patterns of contemporary Native American adolescents.

AIM

This study examines the dietary composition of Native American adolescents residing in upstate New York at the Akwesasne Mohawk Nation. The goal of this investigation is to assess the food patterns of Akwesasne adolescents via a total diet approach. PARTICIPANTS/SETTING AND METHODS: The sample is comprised of 246 Mohawk adolescents between the ages of 10-16.9 years of age residing at the Akwesasne Mohawk Nation. Food frequency data was collected from adolescents via interview during a cross-sectional study investigating their exposure to environmental pollutants.

RESULTS AND CONCLUSION

Nutrient-dilute but energy-dense foods characterize most of the top 10 dietary sources of energy, carbohydrates, and fat. Although micronutrient intakes are by and large adequate in the sample, micronutrients are most often derived from highly fortified food sources. Adolescent diets contain few naturally-occurring sources of many micronutrients, especially folate and iron. A narrow variety of foods dominate the top dietary sources across both macronutrient and micronutrients, strongly suggesting the need for increased dietary diversity within this age group.

Cultural and health implications of fish advisories in a Native American community

INTRODUCTION

Fish advisories are issued in an effort to protect human health from exposure to contaminants, but Native American communities may suffer unintended health, social, and cultural consequences as a result of warnings against eating local fish. This paper focuses on the Mohawk community of Akwesasne, which lies downstream from a Superfund site, and explores how fish advisories have impacted fish consumption and health.

METHODS

65 Akwesasne community members were interviewed between March 2008 and April 2009. Interviews were semi-structured, lasted from 30-90 minutes and consisted of open-ended questions about the impacts of environmental contamination on the community. Detailed field notes were also maintained during extensive visits between 2007-2011. Interviews were transcribed, and these transcripts as well as the field notes were analyzed in NVivo 8.0. This research received approval from the Akwesasne Task Force on the Environment Research Advisory Committee, as well as the Brown University Institutional Review Board.

RESULTS

Three-quarters of the 50 Akwesasne Mohawks interviewed have ceased or significantly curtailed their local fish consumption due to the issuance of fish advisories or witnessing or hearing about deformities on fish. Many of these respondents have turned to outside sources of fish, from other communities or from grocery stores. This change in fish consumption concerns many residents because cultural and social connections developed around fishing are being lost and because fish has been replaced with high-fat high-carb processed foods, which has led to other health complications. One-quarter of the 50 interviewees still eat local fish, but these are generally middle-aged or older residents; fish consumption no longer occurs in the multi-generational social context it once did.

CONCLUSIONS

Human health in Native American communities such as Akwesasne is intimately tied to the health of the environment. Fish advisories should not be used as an institutional control to protect humans from exposure to contaminants; if Akwesasne are to achieve optimal health, the contaminated environment has to be remediated to a level that supports clean, edible fish.

What's NOT to eat--food adulteration in the context of human biology

Food has nutritional and non-nutritional components. The latter are not well-studied despite the fact that food adulteration has been common. Food adulteration may have reached its peak in cities of Western Europe and the US in the 18th and 19th centuries when foods were often purposely contaminated with additives to increase bulk, attractiveness, disguise spoilage, and increase profit. Effective regulation of food began in the late 19th and 20th centuries. Nevertheless, today food recalls for bacterial contamination are common, while pesticides and compounds from manufacturing are detected in many foods. Foods with strong reputations for healthiness, such as salmon, may have sizable contaminant contents. The contaminant content of many foods varies by origin and season. Nearly all commercially raised salmon has higher contaminant levels than wild caught salmon. Opting out of the commercial food distribution system is an option, but the value depends on the habitat in which the food is obtained. Traditionally, the Akwesasne Mohawk Nation has depended on local fish and wildlife for their diet. Now pollution of local waterways has led to the contamination of many local foods, and levels of the contaminant polychlorinated biphenyls in the Akwesasne Mohawk people reflect current or past dietary patterns. Many other communities in nonurban settings are exposed to contaminants through long-trail distribution of contaminants in food, air, and/or water. Human biologists considering nutrition, disease, growth, reproduction, aging, to name a few areas, may consider the non-nutritional components of food as many have the ability to alter physiological functioning.

Levels of persistent organic pollutant and their predictors among young adults

Exposure to persistent organic pollutants (POPs), such as polychlorinated biphenyls (PCBs), dichlorodiphenyldichloroethane (p,p'-DDE), and hexachlorobenzene (HCB) continues to be of concern due to their ubiquitous distribution and high persistence. Current toxicant body burden is still a primary concern within the Akwesasne Mohawk Nation since other studies conducted within the community have shown relationships between these POPs and endocrine disruption. In this article we describe the levels of these toxicants in young adults of the Akwesasne Mohawk Nation between the ages of 17 and 21 years of age (mean age 18.1 years), and investigate potential influences of their current body burden. Seventeen congeners in fourteen chromatographic peaks were detected in 50% or more of the individuals sampled (geometric mean [GM] of the sum of these congeners=0.43 ppb). Congeners 118, 138[+163+164] and 153 had the highest rate of detection (≥98%) within the Akwesasne young adults. Of the other organochlorines, HCB (GM=0.04 ppb) and p,p'-DDE (GM=0.38 ppb) were found in 100% and 99% of the sample respectively. Significantly higher levels of PCBs were found among individuals who were breastfed as infants, were first born, or had consumed local fish within the past year. When compared to levels of p,p'-DDE, HCB, and 13 specific congeners reported by the CDC for youth between the ages of 12 and 19 years, the geometric means of several congeners (CBs 99, 105, 110, and 118) among the Akwesasne were higher than the reported CDC 90th percentile. In contrast, levels of CB 28 in Akwesasne young adults were ~50% or less than those of the CDC cohort. p,p'-DDE and HCB levels were generally higher in the CDC cohort (GM of 0.516 and 0.065 ppb, respectively for Mohawks vs. 2.51 and 0.123, respectively, for CDC). Concentrations of non-persistent PCBs among this sample of Akwesasne young adults were higher than those reported by the CDC suggesting continued exposure, but lower than those associated with severe contamination. Additional research into the concentration trends of individual PCB congeners within Akwesasne youth and young adults is warranted to further improve our insight into the determinants and influences of organochlorine concentrations within members of the Akwesasne community.

Native Americans and cancer risks: moving toward multifaceted solutions

Native Americans experience some of the poorest health statistics of any people in the United States, including rising cancer risks. If we are to truly understand and address health concerns among Native Americans, we need multifaceted interventions and policy solutions. Much of the current attention to Native American health issues examines behavioral health patterns and related interventions (that is, smoking rates and programs to moderate them). While such programs are necessary, they are not sufficient. It is imperative that the impact of the environment, including toxic waste exposure, be considered when examining cancer risk and moving toward solutions that reduce that risk for Native Americans. This article examines cancer risk factors related to both health behaviors and the physical environment. By examining these two areas, we can begin to understand the risks and move toward appropriate programmatic and policy solutions.

Environmental influences on human growth and development: historical review and case study of contemporary influences

Over the past 100 years, the study of environmental influences on human physical growth and development has focused on the influences of social and economic factors; family and household characteristics; urbanization/modernization; nutrition; and features of the physical environment such as altitude, temperature and climate. Continuing in this tradition are current investigations into the roles of pollutants and other aspects of the human-made environment in affecting patterns of human growth and development, specifically the timing of sexual maturation and the development of obesity. Some of the methodological problems in conducting such studies are presented, as are results from an ongoing investigation among one Native American community that show relationships of pollutants to sexual maturation, overweight/obesity and thyroid system function which can impact growth and maturation.

Relationships of putative endocrine disruptors to human sexual maturation and thyroid activity in youth

Endocrine disruption has become a significant human health concern, but is difficult to study outside of the laboratory for several reasons including the multiplicity of exposures, the difficulty in assessing each exposure, and the variety of possible outcomes among human populations. This review summarizes our studies of the relationships of measured persistent organic pollutants (PCBs, p,p'-DDE, HCB and mirex), and heavy metals (lead and mercury), to outcomes directly related to thyroid function and sexual maturation. These studies were conducted in a sample of Native American youth from the Akwesasne Mohawk community. The participants were first studied during puberty (10-16.9 years of age) and then at approximately 18 years of age. Results from these studies show that PCB levels are positively related to TSH and negatively to free T4. Further, these effects are conditioned by breastfeeding history. Anti-thyroid peroxidase antibody levels also are related to PCB levels suggesting elevated risk of autoimmune disease among the exposed. Earlier age at menarche is associated with higher PCB levels while risk of delay is associated with higher lead levels. Some evidence that the timing of exposure produces different effects is presented, and the level of exposure in the participants suggests that effects observed may be relevant to a considerable proportion of the US population. Further investigations are warranted to determine effect thresholds and mechanisms.

Analysis of PCB congeners related to cognitive functioning in adolescents

To investigate the characteristics of PCBs that are linked to cognitive functioning, those congeners that were concurrently found in 271 Mohawk adolescents were grouped according to structure (dioxin-like or non-dioxin-like) and persistence (persistent or low-persistent). After the effects of the congener groups were orthogonalized, regression analyses (controlling for a number of variables found to be related to the cognitive outcomes) examined the relationship of each congener group to scores on three cognitive tests (the non-verbal Ravens Progressive Matrices, the Test of Memory and Learning, and the Woodcock Johnson-Revised). Five subtests from these cognitive tests were found to be associated with one or more PCB congener groups, most often at a moderate level. Two measures of long-term memory (Delayed Recall and Long Term Retrieval) were associated with all four congener groups. Nevertheless, examination of the role of individual congeners in the significantly related congener groups revealed that almost all congeners associated with cognitive outcomes were non-dioxin-like and ortho-substituted. A notable exception was the Ravens test where scores were associated only with dioxin-like congeners. This finding adds to the limited evidence of neurotoxic effects of dioxin-like congeners. Auditory Processing was related only to the persistent congener group. The association of the non-persistent congener group with three cognitive test scores (Delayed Recall, Long Term Retrieval and Comprehension-Knowledge) suggests that the Mohawk adolescents have experienced continuing or recent environmental exposure to PCBs that is sufficient to result in detectable cognitive decrements. Comparison of our findings with those of other human studies was limited by the relative lack of specificity of both PCB measures and cognitive outcome measures in much previous work.

Evidence of an age-related threshold effect of polychlorinated biphenyls (PCBs) on neuropsychological functioning in a Native American population

Polychlorinated biphenyls (PCBs) have been suspected for some time of having adverse effects on neuropsychological functioning in humans. While there is evidence of slowing of cognitive function in children associated with exposure to PCBs, the evidence of comparable effects on adults is far less well understood. We report here on the neuropsychological evaluation of 277 Native American adults, ranging in age from 18 to 79, who were exposed to PCBs by way of environmental contamination in the St. Lawrence region of upstate New York. PCB body burden was estimated by 101 PCB congeners and neuropsychological functioning was assessed by a battery of 18 tests. Spline regression models were fitted to the latent variables of memory, motor function, and higher-order executive functioning. After adjusting for age, gender, and education the analyses revealed a threshold effect of PCBs at approximately 2 ppb. An age-by-PCB interaction effect was also observed for several variables which suggests that the threshold effect was largely confined to the age range of 40-79 and was not observable in the 18-40-year-old group. Implications of these results are discussed in comparison to previously published similar work with adults and in terms of its potential clinical meaningfulness.

Persistent organic pollutants and anti-thyroid peroxidase levels in Akwesasne Mohawk young adults

Persistent organic pollutants, such as polychlorinated biphenyls (PCBs), hexachlorobenzene (HCB), and p,p'-dichlorophenyldichloroethylene (DDE), have been found to elicit a broad spectrum of biologic, metabolic, and immunologic responses. The potential of these pollutants to impair immune responses and trigger autoimmune disease is of growing concern, given their structural similarity to thyroid hormones and their potential to modulate the mechanisms and interfere with the binding of these hormones. We examine the relationship of different groupings of PCBs, according to chlorination and structure, and of p,p'-DDE and HCB to anti-thyroid peroxidase antibody, a useful tool in the evaluation of thyroid dysfunction, among 115 young adults of the Akwesasne Mohawk Nation. Overall, 18 participants (15.4%) had anti-thyroid peroxidase antibodies (TPOAb) levels above the normal laboratory reference range (23% of females, 9% of males). Among participants who were breast fed (n=47), those with an elevated TPOAb level had significantly higher levels of all PCB groupings, with the exception of levels of non-persistent PCBs which did not differ significantly. Levels of p,p'-DDE were also significantly elevated, while HCB and mirex were not higher among those with elevated TPOAb. Also, after stratifying by breast-feeding status, participants who were breast fed showed significant, positive relationships between TPOAb levels and all PCB groupings, except groups comprised of non-persistent PCBs, and with p,p'-DDE, HCB, and mirex. No effects were evident among non-breast-fed young adults. Further studies are necessary to elucidate the site and mechanism of action of these persistent organic pollutants (POPs) and to establish thresholds for these effects, especially among populations with background levels of toxicant exposure.

Relationship of thyroid hormone levels to levels of polychlorinated biphenyls, lead, p,p'- DDE, and other toxicants in Akwesasne Mohawk youth

BACKGROUND

It is well documented that acute exposure to high levels of persistent organic pollutants, such as polychlorinated biphenyls (PCBs), p,p'-dichlorophenyldichloroethylene (p,p'-DDE), and hexachlorobenzene (HCB), can affect human health including thyroid function. Chronic exposure to multiple toxicants is common but difficult to analyze, and most prior studies have focused on adults or newborns, creating a gap in our understanding of multitoxicant effects among adolescents.

OBJECTIVE

We investigated whether levels of PCBs, p,p'-DDE, HCB, mirex, lead, and mercury reflecting past chronic exposure are associated with alterations in levels of thyroid-stimulating hormone (TSH), triiodothyronine (T(3)), total thyroxine (TT(4)), and free thyroxine (FT(4)) among older children and adolescents.

METHODS

The sample consists of youth from the Akwesasne Mohawk Nation (n=232) who reside in proximity to several industries that have contaminated the local environment. We used multiple regression analysis to examine the effect of PCB groupings, p,p'-DDE, HCB, lead, and mercury on thyroid hormones after adjusting for sociodemographic covariates and controlling for all other toxicants.

RESULTS

Exposure to PCBs affects the thyroid hormone profile in adolescents. The group of persistent PCBs was positively associated with TSH but inversely related to FT(4). Nonpersistent PCBs were significantly and negatively related to FT(4) only. HCB was negatively associated with T(4), and lead was positively associated with T(3). Breast-fed adolescents had higher levels of persistent PCBs and p,p'-DDE but not of nonpersistent PCBs or any other toxicant when compared with non-breast-fed adolescents. Though having lower levels of persistent PCBs and p,p'-DDE, non-breast-fed adolescents exhibited significant relationships between persistent PCBs and TSH and FT(4), but breast-fed adolescents did not. It appears that PCBs from breast milk obscure the relationship between prenatal PCB exposure and thyroid function by adding random variation in PCB levels.

CONCLUSION

Our results demonstrate a reduction in thyroid function in adolescents in relation to their current serum levels of PCBs. These observations are consistent with the hypothesis that pre-natal exposure to PCBs alters thyroid function in a long-lasting manner but does not exclude the possibility that postnatal exposure is influential also.

High serum PCBs are associated with elevation of serum lipids and cardiovascular disease in a Native American population

We have investigated the relationships among the concentration of total serum polychlorinated biphenyls (PCBs), various PCB congener groupings, and three pesticides to total serum lipids in humans with and without self-reported cardiovascular disease. Blood samples were obtained from 335 adult Akwesasne Mohawks, and were analyzed for 101 PCB congeners, mirex, dichloro-diphenyl-dichloro-ethylene (DDE), and hexachlorobenzene (HCB), as well as serum triglycerides and cholesterol. Structural equation modeling, following the definition of latent variables by means of confirmatory factor analysis, was used to analyze the relationships between serum lipids with PCBs and heart disease. There were significant associations among PCBs, lipids, age, and body mass index (BMI), a fact which justified the application of the structural equation model. Gender of the participant was unrelated to any of the remaining study variables. The results of this study are consistent with a model in which age is considered as both an exogenous explanatory variable and a biological driving mechanism for the acquisition of PCBs. Moreover, the results of this study are consistent with the conclusion that PCBs, acting through P450 enzymes, are directly responsible for increased synthesis of cholesterol and triglycerides, substances known to be major risk factors for cardiovascular disease.

Advancing biocultural models by working with communities: a partnership approach

Culture and human behavior are recognized today as major forces acting on human biological variation around the world. Studies of the relationships between biology and processes, such as modernization, urbanization, and social stratification, are prominent in our journals and meetings. An ongoing study of the interrelationships between toxicant exposure (organochlorines, lead, and mercury), health, and culture among youth of the Mohawk Nation at Akwesasne is located within this context and is used to analyze the strengths and challenges of a partnership approach to biocultural research. To assist in modeling the complex relationships between health, behavior, and culture, we have employed concepts from contemporary social theory, integrated qualitative and quantitative research, and implemented community-based research principles to develop a partnership approach to research in human biology. The community is directly involved in identifying research goals, developing research protocols appropriate for local cultural sensitivities and complexities, implementing the protocols in the field, and collaborating in the analysis and publication of results. We show the utility of this approach for understanding the relationships of toxicants to behavior and biological outcomes (adolescent growth, sexual maturation, and endocrine system alteration); as well as how it facilitates the agency of participants and communities involved in research, and brings greater social engagement to the development of the new human biology.

Gendered dimensions of environmental health, contaminants and global change in Nunavik, Canada

As has been well-documented in the scholarly literature over the last two decades, contaminants pose a potentially significant threat to the short and long-term health of Arctic human and natural environments and raise questions of social and environmental justice. Studies link contaminants such as heavy metals, persistent organic pollutants and radionuclides with the use of traditional country foods by Indigenous peoples including the Inuit. Adversely impacting Inuit communities in a myriad of ways, contaminants represent one manifestation of global change across the circumpolar North. Focusing on the community of Inukjuak, Nunavik (Northern Québec), Canada, this paper investigates the roles of Inuit women and men vis-à-vis participation in hunting activities and the identification of contaminants, and demonstrates how women and men construct the lead contaminant issue differently. Additionally, the paper explores why including the perspectives of both is critical to the development of effective environmental health policies, programs and strategies in response to these contaminants.

An observational study of the potential exposures of preschool children to pentachlorophenol, bisphenol-A, and nonylphenol at home and daycare

The Children's Total Exposure to Persistent Pesticides and Other Persistent Organic Pollutants (CTEPP) study investigated the potential exposures of 257 preschool children, ages 1 1/2-5 yr, and their primary adult caregivers to more than 50 anthropogenic chemicals. Field sampling took place in selected counties in North Carolina (NC) and Ohio (OH) in 2000-2001. Over a 48-h period in each child's daycare center and/or home, food, beverages, indoor air, outdoor air, house dust, soil, participants' hand surfaces and urine were sampled. Additional samples-transferable residues, food preparation surface wipes, and hard floor surface wipes-were collected in the approximately 13% of the homes that had pesticide applications within the 7 days prior to field sampling. Three phenols were among the measured chemicals: pentachlorophenol (PCP), bisphenol-A [2,2-bis(4-hydroxyphenyl)propane], and nonylphenol (4-n-nonylphenol). Nonylphenol (NP) was detected in less than 11% of the samples in any medium. Among samples that were collected at all participants' homes and daycare centers, PCP was detected in >50% of indoor air, outdoor air, house dust, and urine samples; bisphenol-A (BPA) was detected in >50% of indoor air, hand wipe, solid food, and liquid food samples. The concentrations of the phenols in the sampled media were measured, and the children's potential exposures and potential absorbed doses resulting from intake through the inhalation, dietary ingestion, and indirect ingestion routes of exposure were estimated. The children's potential exposures to PCP were predominantly through inhalation: 78% in NC and 90% in OH. In contrast, their potential exposures to BPA were predominantly through dietary ingestion: 99%, for children in both states. The children's estimated exposures to PCP, calculated from the amounts excreted in their urine, exceeded their estimated maximum potential intake, calculated from the multimedia PCP concentrations, by a factor greater than 10. This inconsistency for PCP highlights the need for further research on the environmental pathways and routes of PCP exposure, investigation of possible exposures to other compounds that could be metabolized to PCP, and on the human absorption, metabolism, and excretion of this phenol over time periods longer than 48 h.

Selected anthropometric measurements of Akwesasne Mohawk youth: Skinfolds, circumferences, and breadths

Nationally, Native American youth have been shown to be at risk for overweight, and an increased prevalence of obesity among Native American children has been consistently reported. We describe skinfolds, circumferences, and body breadths to assess body size and shape of Akwesasne Mohawk youth (n = 271) between the ages of 10.0 and 16.99. Akwesasne is a sovereign nation with territory in New York state and Canada. Sex- and age-specific comparisons were made to reference values published from the Advance Data from Vital and Health Statistics and from the Third National Health and Examination Survey (NHANES III). Akwesasne youth have thicker skinfolds and larger circumferences than youth in the national surveys. Additionally, these cross-sectional data indicate that body fat is more centrally distributed in Akwesasne Mohawk boys and girls. Given the numerous studies emphasizing the importance of body fat distribution as a risk factor for chronic, obesity-related diseases prevalent within Native American communities, and the high level of fatness presented in this study, more concerted efforts need to be applied to help reduce the development of overweight in children from an early age.

PCBs and cognitive functioning of Mohawk adolescents

This paper reports on the relationships between the cognitive functioning and PCB current body burdens of adolescents in the Mohawk Nation of Akwesasne where there is concern about industrial pollution of the environment. Three cognitive tests (Woodcock Johnson-Revised, Test of Memory and Learning, and Ravens Progressive Matrices) provide 13 subtests that allow a variety of cognitive outcomes to be assessed. A summary measure of PCB level was created from the congeners detected in at least 50% of the participants. The most notable finding was the significant negative relationship between PCB levels and two separate measures of long term memory. There was also a negative relationship with a measure of comprehension and knowledge. Significant relationships were not large, but provide evidence of subtle negative effects of PCB exposure.

Effects of Pollution on Human Growth and Development: An Introduction

Pollution is a worldwide problem and its potential to influence the physiology of human populations is great. Studies of human growth and development in relation to pollution have increased in number and quality since the mid-twentieth century. Many studies have found that some pollutants have detrimental effects on human growth, particularly prenatal growth. The heavy metal, lead, is commonly found in human populations and is related to smaller size at birth and studies have reported decrements that range up to about 200 grams. Noise stress from transportation sources also is related to reduced prenatal growth with somewhat smaller decrements reported. Studies of humans exposed to polychlorinated biphenyls, one of the persistent organic pollutants, have reduced size at birth, advanced sexual maturation and altered hormone levels related to thyroid regulation. Thus different pollutants exert effects through different physiological pathways. However, some studies have not observed these effects, which indicates that the situation is complex and requires further study with better study designs. Determining the effects of pollutants on human physiology and growth is difficult as it requires fairly large numbers of subjects who are not purposely exposed but for whom exposure can be measured. These effects of pollutants and the mechanisms of effect require further study to understand and, it is hoped, to blunt or block any detrimental effects on human health and well-being.

Health disparities and toxicant exposure of Akwesasne Mohawk young adults: a partnership approach to research

In this article we describe a research partnership between the Akwesasne Mohawk Nation and scientists at the University at Albany, State University of New York, initiated to address community and scientific concerns regarding environmental contamination and its health consequences (thyroid hormone function, social adjustment, and school functioning). The investigation focuses on cultural inputs into health disparities. It employs a risk-focusing model of biocultural interaction: behaviors expressing cultural identity and values allocate or focus risk, in this instance the risk of toxicant exposure, which alters health status through the effects of toxicants. As culturally based behaviors and activities fulfill a key role in the model, accurate assessment of subtle cultural and behavioral variables is required and best accomplished through integration of local expert knowledge from the community. As a partnership project, the investigation recognizes the cultural and socioeconomic impacts of research in small communities beyond the production of scientific knowledge. The components of sustainable partnerships are discussed, including strategies that helped promote equity between the partners such as hiring community members as key personnel, integrating local expertise into research design, and developing a local Community Outreach and Education Program. Although challenges arose during the design and implementation of the research project, a collaborative approach has benefited the community and facilitated research.

Assessment of human exposure to polychlorinated biphenyls and polybrominated diphenyl ethers in Japan using archived samples from the early 1980s and mid-1990s

Persistent organic pollutants have been linked to various adverse effects on human health. We conducted a retrospective exposure assessment for 11polychlorinated biphenyl (PCB) congeners and 4 polybrominated diphenyl ether (PBDE) congeners. We analyzed paired samples of blood and food duplicate portions collected in the 1980s (1980 survey, N=40) and the mid-1990s (1995 survey, N=40) from females (five participants from each of eight sites per survey) living throughout Japan, from Hokkaido to Okinawa. The study populations in the 1980 and 1995 surveys were different but had lived in the same community. We measured PCBs and PBDEs in serum and PCBs in diet. Total serum PCBs (ng/g lipid) [geometric mean (geometric standard deviation)] were similar in the 1980 [163.0 (1.7)] and the 1995 [142.6 (2.0)] surveys. In contrast, dietary intake (ng/day) between 1980 and 1995 decreased significantly, from 522.8 (2.5) to 165.9 (3.3), respectively, (P<0.05). We classified the participants by birth year-before 1941 (older generation) and equal to or after 1941 (younger generation). Serum PCB levels decreased significantly in the younger generation, from 179.1 (1.8) in the 1980 survey to 115.4 (2.0) in the 1995 survey (P<0.05). However, in the older generation, serum levels (ng/g lipid) did not change: 150.4 (1.6) in the 1980 survey and 180 (1.8) in the 1995 survey. Total PBDE serum levels (ng/g lipid) increased significantly during the 15 years, from 0.5 (3.5) to 1.8 (3.7) (P<0.05). At the Shimane site, PBDE serum levels (ng/g lipid) increased 20-fold, from 1.3 (4.8) to 26.0 (5.0). The serum levels of PCBs decreased in the younger generation but not in the older, although levels in daily intakes decreased significantly. Exposure levels of PBDEs appear to be increasing in an area-specific manner.

Height, weight, and body mass index among Akwesasne Mohawk youth

Information on the growth of contemporary Native American adolescents is limited. A few studies have shown that Native Americans have growth patterns that may differ from U.S. reference values. We describe basic anthropometric characteristics (height and weight) of Mohawk youth between the ages of 10.0 and 16.99 years from the Akwesasne Mohawk Nation. Body mass index (BMI) was calculated. Mean height of Akwesasne Mohawk youth approximates the 50th percentile of reference values as determined by the 2000 Center for Disease Control and Prevention (CDC) growth charts. At every age, weight means of males approximate or exceed the 90th percentile and all mean weights of females approximate the 85th percentile. Akwesasne males are significantly taller than females from age 14 on and significantly heavier at ages 14 and 16. All age-specific BMI means for males are at or above the 90th percentile and females' means are at or above the 85th. The potential for long-term health effects associated with being overweight has implications for the future health of young Native Americans.

Polychlorinated biphenyl (PCB) exposure assessment by multivariate statistical analysis of serum congener profiles in an adult Native American population

The major determinants of human polychlorinated biphenyl (PCB) body burden include the source and route of exposure and the toxicokinetic processes occurring after uptake. However, the relative importance of each factor for individual subjects cannot currently be determined. The present study characterizes levels and patterns of PCB congeners in a large cohort of adult Akwesasne Mohawks with historical PCB exposure. Total serum PCB ranged from 0.29 to 48.32 ng/g and was higher in adult men than in women (median of 3.81 vs. 2.94 ng/g). The mean serum congener profile for the full cohort was dominated by persistent penta- to hepta-chlorinated biphenyls; several labile congeners were also prominent. In order to provide additional information on individual body burden determinants, multivariate exploratory data analysis techniques were applied to the congener-specific serum PCB data. A self-training receptor model, polytopic vector analysis (PVA), was employed to determine the number, composition, and relative proportions of independent congener patterns that contributed to the overall serum PCB profile for each Mohawk subject. PVA identified five such patterns, each of which was characterized by a unique mix of congeners. One pattern observed in a limited number of Mohawks was similar to those reported for air sampled near contaminated sediment deposits at Akwesasne and for volatilized Aroclor 1248 and is hypothesized to reflect recent inhalation exposure in these subjects. A second pattern was consistent with unaltered Aroclor 1254. A third pattern, resembling Aroclor 1262 but without labile congeners, was correlated with age and is interpreted as representing a lifetime PCB accumulation profile. The final two patterns were dominated by subsets of major persistent congeners and are hypothesized to reflect intermediate bioaccumulation profiles and/or differences in individual toxicokinetics. The results confirm the utility of a multivariate exploratory analysis approach to congener-specific PCB data and provide additional insight into the exposure and individual factors that determine PCB body burden in this population.

Rejecting, revitalizing, and reclaiming: First Nations work to set the direction of research and policy development

BACKGROUND

The history and legacy of Western, colonial research methodologies and policy frameworks continue to create and maintain dichotomies of superior/inferior, and valued/not valued between Western and First Nations cultures, peoples and knowledge.

METHODS

This article was written to awaken discussion on how First Nations are working to shape the direction of research and policy development. It draws upon the author's personal observations and experiences of Western and Indigenous frameworks. The author also draws upon the growing body of work on this issue presented by indigenous researchers and scholars.

FINDINGS

The Health Information Research Committee of the Assembly of Manitoba Chiefs rejects colonial research frameworks and promotes and supports culturally-respectful research. The Dakota in Manitoba are identifying our own Quality of Life indicators and developing policies based on our own cultural values. The Mohawk of Akwesasne have developed research ethics and protocols based on their cultural principles of skennen (peace), kariwiio (good word), and kasastensera (strength).

CONCLUSION

First Nations people in Canada and the world are increasingly rejecting Western, colonial frameworks of research and policy development. Instead, we are reclaiming our right to be who we are, and we are revitalizing our cultures through promotion and utilization of indigenous research methodologies and development of culturally-rooted policy. Though the response of researchers and policy-makers is not yet known, these developments will continue into the future due to the commitment and work of First Nations people.

Relationship of lead, mercury, mirex, dichlorodiphenyldichloroethylene, hexachlorobenzene, and polychlorinated biphenyls to timing of menarche among Akwesasne Mohawk girls

BACKGROUND

Children are commonly exposed at background levels to several ubiquitous environmental pollutants, such as lead and persistent organic pollutants, that have been linked to neurologic and endocrine effects. These effects have prompted concern about alterations in human reproductive development. Few studies have examined the effects of these toxicants on human sexual maturation at levels commonly found in the general population, and none has been able to examine multiple toxicant exposures. The aim of the current investigation was to examine the relationship between attainment of menarche and levels of 6 environmental pollutants to which children are commonly exposed at low levels, ie, dichlorodiphenyldichloroethylene (p,p'-DDE), hexachlorobenzene (HCB), polychlorinated biphenyls (PCBs), mirex, lead, and mercury.

METHODS

This study was conducted with residents of the Akwesasne Mohawk Nation, a sovereign territory that spans the St Lawrence River and the boundaries of New York State and Ontario and Quebec, Canada. Since the 1950s, the St Lawrence River has been a site of substantial industrial development, and the Nation is currently adjacent to a US National Priority Superfund site. PCB, p,p'-DDE, HCB, and mirex levels exceeding the US Food and Drug Administration recommended tolerance limits for human consumption have been found in local animal species. The present analysis included 138 Akwesasne Mohawk Nation girls 10 to 16.9 years of age. Blood samples and sociodemographic data were collected by Akwesasne community members, without prior knowledge of participants' exposure status. Attainment of menses (menarche) was assessed as present or absent at the time of the interview. Congener-specific PCB analysis was available, and all 16 PCB congeners detected in >50% of the sample were included in analyses (International Union of Pure and Applied Chemistry numbers 52, 70, 74, 84, 87, 95, 99, 101 [+90], 105, 110, 118, 138 [+163 and 164], 149 [+123], 153, 180, and 187). Probit analysis was used to determine the median age at menarche for the sample. Binary logistic regression analysis was used to determine predictors of menarcheal status. Six toxicants (p,p'-DDE, HCB, PCBs, mirex, lead, and mercury) were entered into the logistic regression model. Age, socioeconomic status (SES), and BMI were tested as potential cofounders and were included in the model at P < .05. Interactions among toxicants were also evaluated.

RESULTS

Toxicant levels were measured in blood for this sample and were consistent with long-term exposure to a variety of toxicants in multiple media. Mercury levels were at or below background levels, all lead levels were well below the Centers for Disease Control and Prevention action limit of 10 microg/dL, and PCB levels were consistent with a cumulative, continuing exposure pattern. The median age at menarche for the total sample was 12.2 years. The predicted age at menarche for girls with lead levels above the median (1.2 microg/dL) was 10.5 months later than that for girls with lead levels below the median. In the logistic regression analysis, age was the strongest predictor of menarcheal status and SES was also a significant predictor but BMI was not. The logistic regression analysis that corrected for age, SES, and other pollutants (p,p'-DDE, HCB, mirex, and mercury) indicated that, at their respective geometric means, lead (geometric mean: 0.49 microg/dL) was associated with a significantly lower probability of having reached menarche (beta = -1.29) and a group of 4 potentially estrogenic PCB congeners (E-PCB) (geometric mean: 0.12 ppb; International Union of Pure and Applied Chemistry numbers 52, 70, 101 [+90], and 187) was associated with a significantly greater probability of having reached menarche (beta = 2.13). Predicted probabilities at different levels of lead and PCBs were calculated on the basis of the logistic regression model. At the respective means of all toxicants and SES, 69% of 12-year-old girls were predicted to have reached menarche. However, at the 75th percentile of lead levels, only 10% of 12-year-old Mohawk girls were predicted to have reached menarche; at the 75th percentile of E-PCB levels, 86% of 12-year-old Mohawk girls were predicted to have reached menarche. No association was observed between mirex, p,p'-DDE, or HCB and menarcheal status. Although BMI was not a significant predictor, we tested BMI in the logistic regression model; it had little effect on the relationships between menarcheal status and either lead or E-PCB. In models testing toxicant interactions, age, SES, lead levels, and PCB levels continued to be significant predictors of menarcheal status. When each toxicant was tested in a logistic regression model correcting only for age and SES, we observed little change in the effects of lead or E-PCB on menarcheal status.

CONCLUSIONS

The analysis of multichemical exposure among Akwesasne Mohawk Nation adolescent girls suggests that the attainment of menarche may be sensitive to relatively low levels of lead and certain PCB congeners. This study is distinguished by the ability to test many toxicants simultaneously and thus to exclude effects from unmeasured but coexisting exposures. By testing several PCB congener groupings, we were able to determine that specifically a group of potentially estrogenic PCB congeners affected the odds of reaching menarche. The lead and PCB findings are consistent with the literature and are biologically plausible. The sample size, cross-sectional study design, and possible occurrence of confounders beyond those tested suggest that results should be interpreted cautiously. Additional investigation to determine whether such low toxicant levels may affect reproduction and disorders of the reproductive system is warranted.

Rejecting, revitalizing, and reclaiming: First Nations work to set the direction of research and policy development

BACKGROUND

The history and legacy of Western, colonial research methodologies and policy frameworks continue to create and maintain dichotomies of superior/inferior, and valued/not valued between Western and First Nations cultures, peoples and knowledge.

METHODS

This article was written to awaken discussion on how First Nations are working to shape the direction of research and policy development. It draws upon the author's personal observations and experiences of Western and Indigenous frameworks. The author also draws upon the growing body of work on this issue presented by indigenous researchers and scholars.

FINDINGS

The Health Information Research Committee of the Assembly of Manitoba Chiefs rejects colonial research frameworks and promotes and supports culturally-respectful research. The Dakota in Manitoba are identifying our own Quality of Life indicators and developing policies based on our own cultural values. The Mohawk of Akwesasne have developed research ethics and protocols based on their cultural principles of skennen (peace), kariwiio (good word), and kasastensera (strength).

CONCLUSION

First Nations people in Canada and the world are increasingly rejecting Western, colonial frameworks of research and policy development. Instead, we are reclaiming our right to be who we are, and we are revitalizing our cultures through promotion and utilization of indigenous research methodologies and development of culturally-rooted policy. Though the response of researchers and policy-makers is not yet known, these developments will continue into the future due to the commitment and work of First Nations people.

Thyroid function in relation to burden of PCBs, p,p'-DDE, HCB, mirex and lead among Akwesasne Mohawk youth: a preliminary study

The effects of endocrine disrupting environmental contaminants such as polychlorinated biphenyls (PCBs), hexachlorobenzene (HCB), p,p'-dichlorophenyldichloroethylene (p,p'-DDE), mirex, and lead, are examined in a sample of youth of the Akwesasne Mohawk Nation who are 10-16.9 years of age (n=115). The Akwesasne community is located adjacent to hazardous waste sites where PCBs and other toxicants have contaminated the local ecology. This study examines the relationship between measures of thyroid function and endocrine disrupting environmental toxicants. Both with and without statistical adjustment for other toxicants, as well as age, sex and lipid levels, several indicators of PCB burden are significantly, negatively related to levels of free thyroxine and total thyroxine, and positively to thyrotropin. Lead level was positively related to triidothyronine. Future testing of non-linear relationships is warranted. Despite the linear associations with thyrotropin, free and total thyroxine, PCBs were not related to increased occurrence of these hormones outside the clinically normal range for the testing laboratory.