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.

Wild piscivorous fish, mammals, and birds may be at risk for elevated dietary methylmercury intake and toxicity. In controlled feeding studies, the consumption of diets that contained Hg (as methylmercury) at environmentally realistic concentrations resulted in a range of toxic effects in fish, birds, and mammals, including behavioral, neurochemical, hormonal, and reproductive changes. Limited field-based studies, especially with certain wild piscivorous bird species, e.g., the common loon, corroborated laboratory-based results, demonstrating significant relations between methylmercury exposure and various indicators of methylmercury toxicity, including reproductive impairment. Potential population effects in fish and wildlife resulting from dietary methylmercury exposure are expected to vary as a function of species life history, as well as regional differences in fish-Hg concentrations, which, in turn, are influenced by differences in Hg deposition and environmental methylation rates. However, population modeling suggests that reductions in Hg emissions could have substantial benefits for some common loon populations that are currently experiencing elevated methylmercury exposure. Predicted benefits would be mediated primarily through improved hatching success and development of hatchlings to maturity as Hg concentrations in prey fish decline. Other piscivorous species may also benefit from decreased Hg exposure but have not been as extensively studied as the common loon.

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The time-dependent stock of PBDEs contained in in-use products (excluding building materials and large vehicles) was estimated for the U.S. and Canada from 1970 to 2020 based on product consumption patterns, PBDE contents, and product lifespan. The stocks of penta- and octaBDE peaked in in-use products at 17,000 (95% confidence interval: 6000-70,000) and 4,000 (1,000-50,000) tonnes in 2004, respectively, and for decaBDE at 140,000 (40,000-300,000) tonnes in 2008. Products dominating PBDE usage were polyurethane foam used in furniture (65% of pentaBDE), casings of electrical and electronic equipment or EEE (80% of octaBDE), and EEE and automotive seating (35% of decaBDE for each category). The largest flow of PBDEs in products, excluding automotive sector, to the waste phase occurred between 2005 and 2008 at ∼10,000 tonnes per year. Total consumption of penta-, octa-, and decaBDE from 1970 to 2020 in products considered was estimated at ∼46,000, ∼25,000, and ∼380,000 tonnes, respectively. Per capita usage was estimated at 10-250, 10-150, and 200-2000 g·capita(-1)·y(-1) for penta-, octa-, and decaBDE, respectively, over the time span. Considering only the first use (no reuse and/or storage) of PBDE-containing products, approximately 60% of the stock of PBDEs in 2014 or ∼70,000 tonnes, of which 95% is decaBDE, will remain in the use phase in 2020. Total emissions to air of all PBDEs from the in-use product stock was estimated at 70-700 tonnes between 1970 and 2020, with annual emissions of 0.4-4 tonnes·y(-1) for each of penta- and octaBDE and 0.35-3.5 tonnes·y(-1) for decaBDE in 2014.

Interplay among immune activation and cancer pathogenesis provides the framework for a novel subspecialty known as immunooncology. In the rapidly evolving field of immunooncology, understanding the tumor-specific immune response enhances understanding of cancer resistance. This review highlights the fundamentals of incorporating precision medicine to discover new immune biomarkers and predictive signatures. Using a personalized approach may have a significant, positive impact on the use of oncolytics to better guide safer and more effective therapies.