This chapter examines the visual performance of Amazonian gold miners and other workers suffering from mercury poisoning. Subjects exposed to mercury displayed a variable degree of spatial vision dysfunction. Both achromatic and chromatic vision were impaired. They had lower achromatic contrast sensitivity and this effect was more pronounced in the medium spatial frequency range. Mercury exposed subjects also had lower red-green and blue-green chromatic contrast sensitivity than control subjects in all tested spatial frequencies.

The present study investigated the visual perimetry and color vision of two Amazonian populations differently exposed to mercury. Ten riverines environmentally exposed to mercury by fish eating and 34 gold-miners occupationally exposed to mercury vapor. The visual perimetry was estimated using the Förster perimeter and the color vision was evaluated using a computerized version of Farnsworth-Munsell test. Riverine and gold-miners' hair mercury concentrations were quantified. Mercury hair concentration of the riverines was significantly higher than that from gold-miners. Riverines had lower perimetric area than the gold-miners. The errors in the hue ordering test of both Amazonian populations were larger than the controls (non-exposed subjects), but there was no difference between themselves. Riverines had significant multiple association between the visual function and hair mercury concentration, while the gold-miners has no significant association with the exposure. We concluded that the different ways of mercury exposure led to similar visual outcomes, with greater impairment in riverines (organic mercury exposed subjects).

No presente estudo, foram avaliados comparativamente os níveis atuais de exposição ao mercúrio e as manifestações neurológicas em ribeirinhos residentes em comunidades situadas no Estado do Pará, Brasil. Participaram do estudo 78 ribeirinhos de Barreiras (bacia do rio Tapajós), 30 de São Luiz do Tapajós (bacia do rio Tapajós) e 49 do Furo do Maracujá (bacia do rio Tocantins). As concentrações de mercúrio total foram quantificadas, em cabelo, pela espectrofotometria de absorção atômica, e a avaliação neurológica foi realizada por meio de testes de rotina. As concentrações de mercúrio nas comunidades do Tapajós foram maiores que as do Tocantins (p < 0,01). A avaliação das alterações neurológicas não mostrou diferença significativa entre as comunidades das áreas expostas e controle para os resultados observados pelo exame neurológico convencional, exceto para desvio da marcha (p < 0,05). Concluiu-se que, apesar dos níveis de exposição ao mercúrio, houve uma baixa frequência de alterações somatossensoriais encontradas por meio de exames neurológicos convencionais.

Children from riverside communities located downstream of gold mining areas may be chronically exposed to relatively high levels of MeHg through the consumption of fish of this region. The objective of this study was to evaluate and compare levels of THg and MeHg in hair of children less than 12 years in communities near mines in the municipality of Itaituba and in communities far from prospecting areas in the city of Abaetetuba. The communities of Itaituba (Barreiras and São Luiz do Tapajós) had THg mean levels of 5.64 ± 5.55 μg·g−1 (0.43–27.82) and 11.41 ± 7.16 μg.g−1 (1.08–28.17), respectively, and an average count of MeHg relative to THg of 92.20% and 90.27%, respectively. In the Maranhão community, the THg average concentrations results were 2.27 ± 2.11 μg·g−1 (0.13–9.54) and the average values were 93.17% for MeHg. Children of Itaituba had average levels of mercury above the limit established by the World Health Organization (10 μg·g−1) and the strong correlation coefficient between the communities (R = 0.968 and P = 0.0001) suggests the hair as an excellent biomarker of human exposure to organic mercury in riverside populations of the Tapajós, which has the intake of fish daily as main source of protein dietary.

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Mercury (Hg) toxicity is governed by cellular thiol compounds and its capacity to generate reactive oxygen radicals and oxidative stress. Selenium (Se) plays a key role in the prevention of the toxic effects of Hg by modulating the activity of several Se-dependent enzymes, including glutathione peroxidase (GSH-Px). In addition, dietary Se can reduce Hg toxicity by directly interacting with either Hg(II) or methylmercury (MeHg) to form inert products, such as HgSe complexes.. Although experimental and environmental data have indicated a protective role for selenium against Hg toxicity, human data are more limited and somewhat conroversial In the Amazon Region of Brazil, Hg pollution is rampant as a result of gold (Au) mining and other anthropogenic factors, leading to pervasive release of large quantities of metallic Hg0 into the environment. Exposure to Hg in this region is associated with direct occupational exposure in the gold mining industry, as well as consumption by in inhabitants of riverside communities of a diet rich in MeHg-contaminated fish. Human exposure to MeHg in the Amazon through the diet has been monitored by measuring Hg and MeHg in hair samples. In this paper, we review the environmental contamination of Hg in the Amazon and detail human exposures in populations of this region. We conclude with a brief synopsis on Se levels in the Amazon population and provide a brief review of data available on the interaction between Hg and Se in this region. Overall, the literature supports the notion that low environmental Se is linked to susceptibility to Hg toxicity and that Se levels could be used as a bioindicator to monitor the health of Hg exposed subjects. However, in light of the limited human data on this subject, further epidemiological studies are needed to clarify how changes in Se levels modify the toxicity of environmental Hg.

Cervical cancer (CC) is the most common type of cancer in women and is the third leading cause of death in most developing countries, causing more than 288,000 deaths in women worldwide each year. The most favourable survival rate is in developed countries, since CC mortality has recently declined in those countries. The purpose of this study was to determine the survival rate and associated factors of CC patients at a reference hospital in the Amazon region. The patient sample included records of 339 patients with cervical cancer who had been hospitalized in Belém, Pará, Brazil from January 2005 to December 2010; the socioeconomic and clinical data were collected between June and September 2016. A survival rate of approximately 84% was observed, and it was found that disease stage (p <0.01), metastasis (p <0.01) and readmission (p <0.01) had significant influences on patient outcome. The impact of these factors on the general survival rate was higher in the Amazon region compared with other regions of Brazil, and the primary survival factors were associated with earlier stages of the disease. However, more national studies are needed on this subject. Our findings may contribute to the development of regional strategies for the prevention of cervical cancer, a reduction in its incidence and mortality rate, an increase in survival time and an improvement in the quality of life of these women.

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