Biomonitoring methylmercury (MeHg) exposure is problematic in resource-limited settings and with difficult-toaccess populations where traditional biomarker approaches present logistical, economic, and ethical issues. The present study aimed to validate the use of dried blood spots (DBS) to assess MeHg exposure in a real-world contaminated field setting. Whole-blood and DBS samples were collected from electronic waste workers (n = 20) from Agbogbloshie (Ghana) in 2017, and DBS were also artificially created in the laboratory using the field-collected blood. Whole-blood MeHg concentrations averaged 0.84 µg/L, which was not different from levels measured in the corresponding DBS samples (field-collected or artificially created). Whole-blood MeHg comprised 61% of the blood total Hg concentrations. Linear regression analysis revealed no differences in MeHg concentrations between whole-blood samples and field-collected DBS (slope 0.89, R 2 = 0.94) and between field and laboratory DBS (slope 0.89, R 2 = 0.96). The MeHg content in DBS punch blanks averaged 0.86 pg and thus was not of concern. These findings indicate that DBS are a suitable tool for assessing MeHg exposure in real-world environmental settings that may be heavily contaminated.
Background: The Minamata Convention on Mercury (Article 4) prohibits the manufacture, import or export of skin-lightening products containing mercury concentrations above 1 ppm. However, there is a lack of knowledge surrounding the global prevalence of mercury-added skin-lightening products. Objective: The objective of this study was to increase our understanding of worldwide human mercury exposure and associated health risks from the use of skin-lightening products. Methods: A systematic search of peer-reviewed scientific literature was performed in four databases (PubMed, Web of Science Core Collection, Scopus, and Toxline). The initial search in July of 2018 identified 1,711 unique scientific articles, of which 34 were ultimately deemed eligible for inclusion after iterative screens at the title, abstract, and whole text levels. A second search was performed in November of 2020 using the same methods, of which another 7 scientific articles were included. All papers were organized according to four data groups 1) "Mercury in products", 2) "Usage of products", 3) "Human biomarkers of exposure"; and 4) "Health impacts", prior to data extraction and synthesis. Results: This review was based on data contained within 41 peer-reviewed scientific papers from 22 countries worldwide published between 2000 and 2020. In total, we captured mercury concentration values from 787 skin-lightening product samples (overall pooled central median mercury level was 0.49 µg/g, IQR: 0.02-5.9) and 1,042 human biomarker measurements from 863 individuals. We also synthesized usage information from 3,898 individuals, and self-reported health impacts associated with using mercury-added products from 832 individuals. Discussion: This review suggests that mercury widely exists as an active ingredient in many skin-lightening products worldwide, and that users are at risk of variable, and often high exposures. These synthesized findings help increase our understanding of the health risks associated with the use of these products.
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