A population-based mercury exposure assessment near an artisanal and small-scale gold mining site in the Peruvian Amazon

Weinhouse, Caren; Gallis, John A.; Ortiz, Ernesto; Berky, Axel; Morales, Ana; Diringer, Sarah E.; Harrington, James M.; Bullins, Paige; Rogers, Laura; Hare-Grogg, John; Hsu‐Kim, Heileen; Pan, William

doi:10.1038/s41370-020-0234-2

Cited by 24 publications

(37 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…CONAMAD is a prospective birth cohort to measure in-utero (fetal) mercury exposure in pregnant mothers and the impact of exposure on newborn health and development. [24,41,42] and we expected, a priori, that mercury exposure would be highest in zones 1 and 2, moderate in zone 3 and low in zone 4. We note that the highest concentration of indigenous communities is in zone 1; however, no indigenous mothers were enrolled.…”

Section: Methodsmentioning

confidence: 91%

“…The construction of the Interoceanic Highway (IOH, completed in 2011) [31,32] and expansion of ASGM over the past two decades, has driven urbanization, internal migration, deforestation, social conflicts and the emergence of dual burdens of disease [33][34][35][36][37]. ASGM is also the underlying cause for widespread MeHg exposure risk as it is related to rapid deforestation, environmental mercury (Hg) release, and biomagnification of MeHg in local fish species and food sources [24,[38][39][40][41][42][43]. Our team led the first populationbased assessment of mercury exposure in the region, estimating that 58% of the population live in communities affected by ASGM and 43% of women of child-bearing age (WCBA, 15-49 years) have hair mercury levels exceeding 2.2 ug/g, a level corresponding to the WHO provisional tolerable weekly intake [24], which was consistent with estimates from our study of mercury exposure of WCBA in native and non-native communities surrounding the Amarakaeri Reserve [44].…”

Section: Cohort Description 1 Setting -Madre De Diosmentioning

confidence: 99%

“…Trace element analyses were performed on hair and blood samples in the Hsu-Kim laboratory at Duke University using similar protocols are previously described [15,33,42]. Briefly, the proximal 2-cm length of hair was cut, weighed, and analyzed for total Hg content by thermal decomposition, amalgamation, atomic absorption spectrometry (Milestone DMA-80).…”

Section: Data Management and Analysismentioning

confidence: 99%

See 2 more Smart Citations

<i>CoNaMad—Cohorte de Nacimiento de Madre de Dios</i> / Madre de Dios Birth Cohort to Study Effects of in-utero Trace Metals Exposure in the Southern Peruvian Amazon

Pan

Weinhouse

Ortiz

et al. 2021

Annals of Global Health

Self Cite

View full text Add to dashboard Cite

Background: In-utero exposure to mercury and other trace metals pose a significant threat to child health and development, but exposures and health impacts in artisanal and small-scale gold mining (ASGM) environments are poorly defined. Objectives:We describe the CONAMAD study design, a prospective birth cohort consisting of multiparous women (18 and over) living in rural and peri-urban Peruvian Amazon communities exposed to ASGM. Methods: Pregnant women are enrolled from health posts across four zones of Madre de Dios, Peru. Data are collected at enrollment, childbirth, and (planned) 36-48 months. At enrollment, hair samples for mercury assessment, demographic and clinical data are obtained. At birth, we obtain venous and cord blood, placenta, hair, toenails, and saliva. Findings: Two hundred seventy mothers were enrolled at an average 20 weeks gestational age with no differences in maternal characteristics across zones. Two hundred fifteen mothers were successfully followed at birth. We obtained 214 maternal and cord blood samples, 211 maternal and 212 infant hair samples, 212 placenta samples, 210 infant saliva samples, and 214 infant dried blood spots. Data collected will allow for testing our primary hypotheses of maternal malnutrition modifying ratios of cord:maternal blood total mercury (tHg), cord blood:maternal hair tHg, and infant:maternal hair tHg, and whether chemical mixtures (Hg, Pb, Cd) have synergistic effects on infant neurodevelopment.Conclusions: CONAMAD is designed to collect and store samples for future processing and hypothesis testing associated with in-utero mercury exposure and child development. We have completed the exposure assessments and will conduct a follow-up of mothers to evaluate early child development outcomes, including developmental delay and growth. These data offer insights into disease mechanisms, exposure prevention, and policy guidance for countries where ASGM is prevalent.

show abstract

Section: Methodsmentioning

confidence: 91%

Section: Cohort Description 1 Setting -Madre De Diosmentioning

confidence: 99%

Section: Data Management and Analysismentioning

confidence: 99%

See 1 more Smart Citation

<i>CoNaMad—Cohorte de Nacimiento de Madre de Dios</i> / Madre de Dios Birth Cohort to Study Effects of in-utero Trace Metals Exposure in the Southern Peruvian Amazon

Pan

Weinhouse

Ortiz

et al. 2021

Annals of Global Health

Self Cite

View full text Add to dashboard Cite

show abstract

“…While economic differences may partially explain higher anemia prevalence in indigenous communities, additional efforts are needed to assess why anemia rates in indigenous communities remain higher than those in non-indigenous communities. Recent studies have shown indigenous communities to have significantly higher levels of mercury that often surpass World Health Organization's guidelines, and have been associated with lower hemoglobin levels [9,20,24]. Lack of effective medical access, poor nutrition, enteric disease or other unknown factors may also play a role.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Peruvian Government Interventions to Reduce Childhood Anemia

Berky

Robie

Ortiz

et al. 2020

Annals of Global Health

Self Cite

View full text Add to dashboard Cite

Background: In Peru, anemia has been a persistent health problem that is known to lead to irreversible cognitive and developmental deficits in children. The Peruvian government has recently made anemia a primary health concern by passing legislation in 2017 that makes anemia an intersectoral priority. This new legislation fortifies previous programs while creating new programs that target specific age groups. Objectives: Evaluate the effectiveness of government programs in Madre de Dios, Peru to reduce anemia prevalence and increase hemoglobin levels among children ages 2-11 years old. Methods: Propensity scores are used to match 688 children enrolled in 2018, after the legislation, and 2,140 children enrolled in previous studies our team conducted in the region between 2014 and 2017, based on sex, age (years), intervention status (prior/post), community income, presence of a health post in the community (yes/no), community type (indigenous, non-indigenous rural, non-indigenous urban) and road access (fraction of the number of months out of the year with road access). A pseudo matched casecontrol analysis to evaluate changes in anemia prevalence and hemoglobin was conducted using t-tests and multivariate models. Program effectiveness is evaluated overall, by age groups (2-4, 5-7 and 8-11 years old), and community type (indigenous vs. urban). Findings: The adjusted odds ratio indicated lower odds of anemia (OR = 0.31, 95%CI 0.17-0.54) for children exposed to the anemia prevention programs vs. those not exposed. The effect was not significantly different across age groups; however, the intervention effects significantly differed by community type among children 8-11 years old, with urban children less likely to benefit from anemia interventions (OR = 0.69, 95% CI 0.38-1.25) compared to indigenous children (OR = 0.21, 95% CI 0.08-0.56). Conclusion: Government programs to reduce anemia in Madre de Dios were found to be associated with reduced anemia prevalence in the study communities. However, the lack of program monitoring precludes the attribution of anemia decline to specific interventions or program components. In addition, regional anemia prevalence remains high according to the 2019 Demographic and Health Survey, suggesting impaired population impact. Program monitoring and evaluation is a key component of health interventions to improve program implementation effectiveness.

show abstract

“…To this end, we quantified the relationship between MeHg and THg contents in hair for individuals in Madre de Dios, Peru (Figure 1), a region that is an epicenter of ASGM activities in the Amazon basin over the last two decades and has experienced mercury releases to the river environment [45][46][47][48][49][50][51]. Mercury exposures to levels that exceed health guidelines have been widely documented for residents of the region [5,12,[52][53][54][55][56]. We quantified THg and MeHg contents in hair obtained from N = 287 individuals (of N = 2167 sampled) from 20 communities located within and near the mining region.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Hair Total Mercury Content as a Biomarker of Methylmercury Exposure to Communities in the Area of Artisanal and Small-Scale Gold Mining in Madre de Dios, Peru

Koenigsmark

Weinhouse

Berky

et al. 2021

IJERPH

Self Cite

View full text Add to dashboard Cite

Total mercury content (THg) in hair is an accepted biomarker for chronic dietary methylmercury (MeHg) exposure. In artisanal and small-scale gold mining (ASGM) communities, the validity of this biomarker is questioned because of the potential for contamination from inorganic mercury. As mining communities may have both inorganic and organic mercury exposures, the efficacy of the hair-THg biomarker needs to be evaluated, particularly as nations begin population exposure assessments under their commitments to the Minamata Convention. We sought to validate the efficacy of hair THg for public health monitoring of MeHg exposures for populations living in ASGM communities. We quantified both THg and MeHg contents in hair from a representative subset of participants (N = 287) in a large, population-level mercury exposure assessment in the ASGM region in Madre de Dios (MDD), Peru. We compared population MeHg-THg correlations and %MeHg values with demographic variables including community location, sex, occupation, and nativity. We observed that hair MeHg-THg correlations were high (r > 0.7) for all communities, regardless of location or nativity. Specifically, for individuals within ASGM communities, 81% (121 of 150 total) had hair THg predominantly in the form of MeHg (i.e., >66% of THg) and reflective of dietary exposure to mercury. Furthermore, for individuals with hair THg exceeding the U.S. EPA threshold (1.0 μg/g), 88 out of 106 (83%) had MeHg as the predominant form. As a result, had urine THg solely been used for mercury exposure monitoring, approximately 59% of the ASGM population would have been misclassified as having low mercury exposure. Our results support the use of hair THg for monitoring of MeHg exposure of populations in ASGM settings where alternative biomarkers of MeHg exposure are not feasible.

show abstract

A population-based mercury exposure assessment near an artisanal and small-scale gold mining site in the Peruvian Amazon

Cited by 24 publications

References 25 publications

<i>CoNaMad—Cohorte de Nacimiento de Madre de Dios</i> / Madre de Dios Birth Cohort to Study Effects of in-utero Trace Metals Exposure in the Southern Peruvian Amazon

<i>CoNaMad—Cohorte de Nacimiento de Madre de Dios</i> / Madre de Dios Birth Cohort to Study Effects of in-utero Trace Metals Exposure in the Southern Peruvian Amazon

Evaluation of Peruvian Government Interventions to Reduce Childhood Anemia

Efficacy of Hair Total Mercury Content as a Biomarker of Methylmercury Exposure to Communities in the Area of Artisanal and Small-Scale Gold Mining in Madre de Dios, Peru

Contact Info

Product

Resources

About