Exposure to total and methylmercury among pregnant women in Suriname: sources and public health implications

Previous research has found that women and children living in rural, interior communities in Suriname have high concentrations of mercury in hair. Freshwater fish from these areas also have high concentrations of mercury. Artisanal and small-scale gold mining operations in parts of the country use elemental mercury to extract gold from soils and sediments. Total mercury and methylmercury concentrations have been determined in hair and blood from pregnant women across the country. Pregnant women from interior communities have significantly higher concentrations of both total and methylmercury in hair (median total mercury in hair 3.64 µg/g) compared with pregnant women from two urban coastal cities, Paramaribo (0.63 µg/g) and Nickerie (0.74 µg/g). Total and methylmercury concentrations in blood and hair are highly correlated (r = 0.986, r = 0.974) with methylmercury making up 86% of the total in blood and 97% of the total in hair. Most women in the interior regions rely heavily on local fish as part of their regular diet, and many live outsides of areas with active ASGM operations. This study demonstrates that diet and fish consumption largely govern mercury exposures in pregnant women in Suriname.

Caribbean Consortium for Research in Environmental and Occupational Health (CCREOH) Cohort Study: influences of complex environmental exposures on maternal and child health in Suriname

PURPOSE

The Caribbean Consortium for Research in Environmental and Occupational Health prospective environmental epidemiologic cohort study addresses the impact of chemical and non-chemical environmental exposures on mother/child dyads in Suriname. The study determines associations between levels of environmental elements and toxicants in pregnant women, and birth outcomes and neurodevelopment in their children.

PARTICIPANTS

Pregnant women (N=1143) were enrolled from December 2016 to July 2019 from three regions of Suriname: Paramaribo (N=738), Nickerie (N=204) and the tropical rainforest interior (N=201). Infants (N=992) were enrolled at birth. Follow-up will take place until children are 48 months old.

FINDINGS TO DATE

Biospecimens and questionnaire data on physiological and psychosocial health in pregnant women have been analysed. 39.1% had hair mercury (Hg) levels exceeding values considered safe by international standards. Median hair Hg concentrations in women from Paramaribo (N=522) were 0.64 µg/g hair (IQRs 0.36-1.09; range 0.00-7.12), from Nickerie (N=176) 0.73 µg/g (IQR 0.45-1.05; range 0.00-5.79) and the interior (N=178) 3.48 µg/g (IQR 1.92-7.39; range 0.38-18.20). 96.1% of women ate fish, respective consumption of the three most consumed carnivorous species, Hoplias aimara, Serrasalmus rhombeus and Cichla ocellaris, known to have high Hg levels, was 44.4%, 19.3% and 26.3%, respectively, and was greater among the interior subcohort. 89% frequently consumed the vegetable tannia, samples of which showed presence of worldwide banned pesticides. 24.9% of pregnant women had Edinburgh Depression Scale scores indicative of probable depression.

FUTURE PLANS

Fish consumption advisories are in development, especially relevant to interior women for whom fish consumption is likely to be the primary source of Hg exposure. Effects of potentially beneficial neuroprotective factors in fish that may counter neurotoxic effects of Hg are being examined. A pesticide literacy assessment in pregnant women is in progress. Neurodevelopmental assessments and telomere length measurements of the children to evaluate long-term effects of prenatal exposures to toxicant mixtures are ongoing.