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The population of Hawai'i has traditionally been high in average fish consumption when compared to the national average. However, information is lacking on patterns of fish consumption among subpopulations. Data on fish consumption in the last 30 days from 11,293 adults was collected with the use of the Hawai'i Health Survey (an annual telephone survey of households and household members) during the years 2007 and 2008 and weighted to represent the adult population of Hawai'i. The US Department of Agriculture's, Environmental Protection Agency, and the United States Food and Drug Administration, recommend 8-12 ounces of fish per week for associated health benefits. Present estimates of fish consumption were skewed to the right (mean 10.5 and median 7.9 ounces) with some adults eating large amounts of fish per day and frequently. It may be of concern, given high amounts of methylmercury in select fish, that 13.7% of adults were eating fish 20 or more times per month. In addition, the serving size increased with increasing number of times per week fish was eaten. The subpopulation variables examined included age, sex, marital status, education, ethnicity, poverty, and demographics representing the adults of Hawai'i. The prevalence of adults consuming 8 or more ounces was highest for other than Honolulu counties, men, ages 18-74, married, with at least one year of college, Filipino and Native Hawaiian ethnicities (White, Japanese, Chinese, and All Others were also examined), employed, and adults living with higher income levels (lower poverty). However, only an estimated 46.9% of adults in Hawai'i were eating the eight or more ounces of fish weekly. Prevalence was lowest for women, Chinese, age >74 years, and the City and County of Honolulu. Adults who rated their general health better (excellent/good compared to fair/poor) were more likely to consume 8 or more ounces of fish per week, significantly for men. Men who rated their physical health higher and their mental health higher (via Optum SF™ Health Surveys) were associated with higher prevalence of consuming 8 or more ounces of fish per week. Higher consumption of the beneficial omega-3 fatty acids associated with fish low in methylmercury needs to be encouraged for those not meeting the recommended ounces of fish per week, particularly women, Chinese, older age groups, and adults living below the poverty level., Competing Interests: None of the authors identify any conflict of interest., (©Copyright 2020 by University Health Partners of Hawai‘i (UHP Hawai‘i).)

Background: Health risks linked with dioxin in fish remain a complex policy issue. Fatty Baltic fish contain persistent pollutants, but they are otherwise healthy food. We studied the health benefits and risks associated with Baltic herring and salmon in four countries to identify critical uncertainties and to facilitate an evidence-based discussion., Methods: We performed an online survey investigating consumers' fish consumption and its motivation in Denmark, Estonia, Finland, and Sweden. Dioxin and methylmercury concentrations were estimated based on Finnish studies. Exposure-response functions for several health endpoints were evaluated and quantified based on the scientific literature. We also quantified the infertility risk of men based on a recent European risk assessment estimating childhood dioxin exposure and its effect on sperm concentration later in life., Results: Baltic herring and salmon contain omega-3 fatty acids and vitamin D, and the beneficial impact of these fishes on cardiovascular diseases, mortality, and the risk of depression and cancer clearly outweighs risks of dioxins and methylmercury in people older than 45 years of age and in young men. Young women may expose their children to pollutants during pregnancy and breast feeding. This study suggests that even in this critical subgroup, the risks are small and the health benefits are greater than or at least similar to the health risks. Value of information analysis demonstrated that the remaining scientific uncertainties are not large. In contrast, there are several critical uncertainties that are inherently value judgements, such as whether exceeding the tolerable weekly intake is an adverse outcome as such; and whether or not subgroup-specific restrictions are problematic., Conclusions: The potential health risks attributable to dioxins in Baltic fish have more than halved in the past 10 years. The new risk assessment issued by the European Food Safety Authority clearly increases the fraction of the population exceeding the tolerable dioxin intake, but nonetheless, quantitative estimates of net health impacts change only marginally. Increased use of small herring (which have less pollutants) is a no-regret option. A more relevant value-based policy discussion rather than research is needed to clarify official recommendations related to dioxins in fish.

The objective of this study was to quantify total mercury in highly popular Amazonian fish pacu, curimatã, jaraqui, and sardinha from the Madeira River and to estimate the exposure to methylmercury from fish consumption. The samples were obtained from two locations - Puruzinho Igarapé and Santa Rosa - near Humaitá, Amazonia, Brazil in two seasons of 2015 (high and low waters). The fish were identified, weighed and measured, and lipids were quantified. Total mercury was determined by gold amalgamation-atomic absorption spectrometry. Mean levels were used to calculate exposure of Amazonian and riverine populations. There was significant correlation (p < 0.05) between length × weight for all fish; length × lipid and weight × lipid were significant only for pacu. Total mercury levels varied along muscle tissue for the fish, except for sardinha; therefore muscle from the dorsal area along the fish were sampled, homogenized and used for analysis. The levels of total mercury varied from 0.01 to 0.46 mg/kg, with higher median levels in sardinha (0.24 mg/kg), followed by curimatã (0.16 mg/kg), jaraqui (0.13 mg/kg) and pacu (0.04 mg/kg), corresponding with the respective feeding habits along the trophic chain. Total mercury levels were not affected by the location of fish capture and by high and low waters seasons. Total mercury correlated significantly with length and weight for jaraqui and with length for sardinha (negative correlation). Total mercury levels in fish complied with legislation; however, exposures to methylmercury from fish consumption overpassed the safe intake reference dose for sardinha for Amazonians; however, for the riverine communities, all of the fish would cause potential health risk, mainly for children and women of childbearing age., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Putative protective effects of selenium (Se) against methylmercury (MeHg) toxicity have been examined but no conclusion has been reached. We recently reported the lack of serious neurological symptoms in a Japanese fish-eating population with high intakes of MeHg and suggested a potential protective role for Se. Here, relationships between levels of Hg and Se in the blood and plasma samples, with a quantitative evaluation of Se-containing proteins, obtained from this population were examined. While levels of the whole-blood Hg (WB-Hg) and plasma Se (P-Se) showed a positive correlation, stratified analysis revealed that they correlated only in samples with higher (greater than the median) levels of MeHg. A food frequency questionnaire showed that consumption of fish/whales correlated with WB-Hg, but not with P-Se, suggesting that the positive correlation between WB-Hg and P-Se might not be the result of co-intake of these elements from seafood. Speciation of plasma Se revealed the differences in the responses of two plasma selenoproteins, glutathione peroxidase (GPx) and selenoprotein P (SePP), in relation to Hg exposure. In the high-Hg group, SePP showed a positive correlation with WB-Hg, but GPx did not. In the low-Hg group, neither SePP nor GPx showed any correlation with WB-Hg. These observations suggest that the increase in P-Se in the high-Hg group might be associated with an increase in SePP, which may, in turn, suggest an increased demand for one or more selenoproteins in various organs, for which SePP supplies the element., (Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.)

People are exposed to methylmercury (MeHg) mainly through fish consumption, which is increasing in Vietnam. However, little information is available on estimating the health risk of MeHg exposure through fish consumption in Vietnam. The present study examined the association between mercury (Hg) levels in hair and selenium (Se) levels in toenails of 196 Vietnamese people and their fish consumption, using a dietary questionnaire to obtain information pertinent for assessing health risk owing to MeHg exposure. The geometric mean of Hg levels in the hair of males and females was 617 ng/g and 575 ng/g, respectively. We found that Hg levels in the hair of 98% of the Vietnamese study subjects were lower than the provisional tolerable weekly intake for MeHg (1.6 µg Hg/kg body weight; which is equivalent to a hair Hg concentration of approximately 2,300 ng/g, with an uncertainty factor of 6.4). There were significant differences in the age-adjusted geometric mean of Hg levels found in hair from females related to their frequency of freshwater fish consumption. The levels of Hg in hair and Se in toenails increased with an increased frequency of marine fish consumption, and both showed a significant positive correlation in subjects who consumed marine fish ≥ once/week. This is the first cross-sectional study to investigate the association between hair Hg levels and fish consumption in Vietnam. These findings provide valuable information for future assessments of the health risk of MeHg exposure through fish consumption in Vietnam.

Objective: The aim of this study was to determine fish consumption habits and contaminant exposures associated with adverse cardiovascular outcomes among older male anglers., Methods: One hundred fifty-four men aged 50 years and older living and fishing in Wisconsin completed a detailed survey and provided hair and blood samples. Associations between fish consumption and body burdens of several contaminants, with self-reported cardiovascular outcomes, were evaluated., Results: Consuming fish species with higher methyl mercury content was positively associated with odds of angina, coronary heart disease (CHD), or heart attack, while consuming fattier species was negatively associated with high blood pressure or high cholesterol. Total mercury in blood was associated with 27% higher odds of heart attack, and certain classes of polychlorinated biphenyls were positively associated with CHD., Conclusion: Total mercury exposures may affect cardiovascular outcomes. Educational interventions promoting consumption of fish low in methyl mercury among older male anglers are needed.

Fish consumption advisories are used to inform citizens in the United States about noncommercial game fish with hazardous levels of methylmercury (MeHg). The US Environmental Protection Agency (USEPA) suggests issuing a fish consumption advisory when concentrations of MeHg in fish exceed a human health screening value of 300 ng/g. However, states have authority to develop their own systems for issuing fish consumption advisories for MeHg. Five states in the south central United States (Arkansas, Louisiana, Mississippi, Oklahoma, and Texas) issue advisories for the general human population when concentrations of MeHg exceed 700 ng/g to 1000 ng/g. The objective of the present study was to estimate the increase in fish consumption advisories that would occur if these states followed USEPA recommendations. The authors used the National Descriptive Model of Mercury in Fish to estimate the mercury concentrations in 5 size categories of largemouth bass-equivalent fish at 766 lentic and lotic sites within the 5 states. The authors found that states in this region have not issued site-specific fish consumption advisories for most of the water bodies that would have such advisories if USEPA recommendations were followed. One outcome of the present study may be to stimulate discussion between scientists and policy makers at the federal and state levels about appropriate screening values to protect the public from the health hazards of consuming MeHg-contaminated game fish., (© 2015 SETAC.)

Due to possible health risks, quantification of mercury accumulation in humans was included in the Flemish biomonitoring programmes FLEHS I (2002-2006) and FLEHS II (2007-2011). The general objective of FLEHS I was to assess regional exposure levels in order to link possible differences in these internal exposure levels to different types of local environmental pressure. Therefore, Hg and MMHg (methylmercury) were only measured in pooled blood samples per region and per age class. In FLEHS II, mercury concentrations were measured in hair of each participant. About 200 adolescents and 250 mothers (reference group) and two times 200 adolescents (2 hotspots) were screened. The main objectives of the FLEHS II study were: (1) to determine reference levels of mercury in hair for Flanders; (2) to assess relations between mercury exposure and possible sources like fish consumption; (3) to assess dose-effect relations between mercury exposure and health effect markers. The results showed that mercury concentrations in the Flemish population were rather low compared to other studies. Mercury levels in the Flemish populations were strongly related to the age of the participants and consumption of fish. Significant negative associations were observed between mercury in hair and asthma, having received breast feeding as a newborn, age at menarche in girls, allergy for animals and free testosterone levels. Significant correlations were also observed between mercury in hair and genes JAK2, ARID4A, Hist1HA4L (boys) and HLAdrb5, PIAS2, MANN1B1, GIT and ABCA1 (girls)., (Copyright © 2013 Elsevier GmbH. All rights reserved.)

Individuals who fish and eat self-caught fish make decisions about where to fish, the type to eat, and the quantity to eat. Federal and state agencies often issue consumption advisories for some fish with high mercury (Hg) concentrations, but seldom provide either the actual metal levels to the general public, or identify the fish that have low contaminant levels. Community participatory research is of growing importance in defining, studying, and resolving complex exposure and risk issues, and this paper is at the intersection of traditional stakeholder approaches and community-based participatory research. The objective of this paper is to describe the process whereby stakeholders (fishers), were involved in directing and refining research questions to address their particular informational needs about mercury levels in fish, potential risks, and methods to maintain health, by balancing the risks and benefits of fish consumption. A range of stakeholders, mainly individual fishers, fishing organizations, and other scientists, were involved at nearly every stage. Community participants influenced many aspects of the design and implementation of the research, in the determination of which fish species to sample, in the collection of the samples, and in the final analyses and synthesis, as well as the communication of results and implications of the research through their fishing club publications, talks and gatherings. By involving the most interested and affected communities, the data and conclusions are relevant to their needs because the fish examined were those they ate and wanted information about, and directly address concerns about the risk from consuming self-caught fish. Although mercury levels in fish presumed to be high in mercury are known, little information was available to the fishermen on mercury levels in fish that were low and thus provided little risk to their families. While community participatory research is more time-consuming and expensive than traditional scientific research, both the process and results are better scientifically in terms of community relevance.

Marine food webs are the most important link between the global contaminant, methylmercury (MeHg), and human exposure through consumption of seafood. Warming temperatures may increase human exposure to MeHg, a potent neurotoxin, by increasing MeHg production as well as bioaccumulation and trophic transfer through marine food webs. Studies of the effects of temperature on MeHg bioaccumulation are rare and no study has specifically related temperature to MeHg fate by linking laboratory experiments with natural field manipulations in coastal ecosystems. We performed laboratory and field experiments on MeHg accumulation under varying temperature regimes using the killifish, Fundulus heteroclitus. Temperature treatments were established in salt pools on a coastal salt marsh using a natural temperature gradient where killifish fed on natural food sources. Temperatures were manipulated across a wider range in laboratory experiments with killifish exposed to MeHg enriched food. In both laboratory microcosms and field mesocosms, MeHg concentrations in killifish significantly increased at elevated temperatures. Moreover, in field experiments, other ancillary variables (salinity, MeHg in sediment, etc.) did not relate to MeHg bioaccumulation. Modeling of laboratory experimental results suggested increases in metabolic rate as a driving factor. The elevated temperatures we tested are consistent with predicted trends in climate warming, and indicate that in the absence of confounding factors, warmer sea surface temperatures could result in greater in bioaccumulation of MeHg in fish, and consequently, increased human exposure.

Studies of neurodevelopmental outcomes in offspring exposed to MeHg from maternal consumption of fish have primarily measured cognitive abilities. Reported associations have been subtle and in both adverse and beneficial directions. Changes in functional outcomes such as school achievement and behavior in exposed children and adolescents have not been examined. We undertook an assessment of school success of children in the Seychelles Child Development Study (SCDS) main cohort to determine if there were any associations with either prenatal or recent postnatal MeHg exposure. The primary endpoints were Seychelles nationally standardized end-of-year examinations given when the cohort children were 9 and 17 years of age. A subgroup (n=215) from the main cohort was also examined at 9 years of age using a regional achievement test called SACMEQ. Prenatal MeHg exposure was 6.8 ppm in maternal hair; recent postnatal exposure was 6.09 ppm at 9 years and 8.0 ppm at 17 years, measured in child hair. Multiple linear regression analyses showed no pattern of associations between prenatal or postnatal exposure, and either the 9- or 17-year end-of-year examination scores. For the subgroup of 215 subjects who participated in the SACMEQ test, there were significant adverse associations between examination scores and postnatal exposure, but only for males. The average postnatal exposure level in child hair for this subgroup was significantly higher than for the overall cohort. These results are consistent with our earlier studies and support the interpretation that prenatal MeHg exposure at dosages achieved by mothers consuming a diet high in fish are not associated with adverse educational measures of scholastic achievement. The adverse association of educational measures with postnatal exposure in males is intriguing, but will need to be confirmed by further studies examining factors that influence scholastic achievement., (Copyright © 2010 Elsevier Inc. All rights reserved.)

The benefits of fish consumption have been known to be the prevention of certain heart disease, neurological disorders and a very important role in fetal brain development. However there has been, in the past, certain doubts on whether fish should be classified as a beneficial meat source as part of a pregnant woman's diet as it has been documented that fish contains harmful substances that could effect a child's cognitive and neuro development. Methylmercury (MeHg), in particular, has been singled out. As it turned-out, with the use of numerous literature reviews, MeHg is not as dangerous as we have been led to believe. It has been suggested that even during neonatal exposure to MeHg as a result of maternal fish consumption one can reverse the harmful effects of MeHg if, after birth, the child is exposed to a favorable environment and a nutritious diet. The role of antioxidants is also important as they can help in reducing the harmful effects of MeHg if administered in sufficient amounts during pregnancy. There are also many fish types that should be avoided during pregnancy, particularly predatory and dark-meat fish as they are associated with high amounts of MeHg. This review shows that the benefits of maternal fish consumption during pregnancy can outweigh the harmful effects of neonatal MeHg exposure.

Recent studies have shown an association between myocardial infarction and the intake of MeHg from fish in amounts near the current reference dose (RfD). Biochemical studies support the association. This article considers the results of recent epidemiological studies in relation to an evaluation of RfD and food guidelines. MeHg levels in certain Danish fish are close to harmful levels if the food guidelines are followed. Revised food guidelines should be based on assessments of the MeHg amount in each fish species.

National fish consumption advisories that are based solely on assessment of risk of exposure to contaminants without consideration of consumption benefits result in overly restrictive advice that discourages eating fish even in areas where such advice is unwarranted. In fact, generic fish advisories may have adverse public health consequences because of decreased fish consumption and substitution of foods that are less healthy. Public health is on the threshold of a new era for determining actual exposures to environmental contaminants, owing to technological advances in analytical chemistry. It is now possible to target fish consumption advice to specific at-risk populations by evaluating individual contaminant exposures and health risk factors. Because of the current epidemic of nutritionally linked disease, such as obesity, diabetes, and cardiovascular disease, general recommendations for limiting fish consumption are ill conceived and potentially dangerous.

Consumption of at least two servings of fish per week is recommended by the American Heart Association (AHA) to achieve cardio-protective effects. However, some fish are contaminated with methylmercury, which may counteract the positive effect of the omega-3 fatty acids, and numerous governments have issued advisories for certain fish species. These mixed messages may be a source of confusion to the consumer and to the health professional. This paper reviews whether it is possible to follow the AHA recommendation for fish consumption while avoiding the risks associated with consuming mercury in amounts in excess of government thresholds.

The Amazon rain forest extends over an area of 7.8x10(6)km(2) in nine countries. It harbors a diverse human population distributed in dense cities and isolated communities with extreme levels of infrastructure. Amazonian forest people, either autochthons or frontier riparians (ribeirinhos) living in isolated areas, share the same environment for survival and nutritional status. The peculiarities of the hydrological cycle determine disease patterns, agricultural conditions, and food availability. Feeding strategies depend heavily on cassava products and fish. These two foods carry toxic substances such as linamarin (naturally present in cassava) and monomethyl mercury (MMHg) (bioconcentrated in fish flesh) that cause neurotoxic diseases in other parts of the world but not in Amazonia, where neurotoxic cases of food origin are rare and not related to these staples. While cassava detoxification processes may partly explain its safe consumption, the Hg concentrations in Amazonian fish are within traditionally safe limits for this population and contribute to an important metabolic interaction with cassava. The gold rush of the 1970s and 1980s brought large-scale environmental disruption and physical destruction of ecosystems at impact points, along with a heavy discharge of metallic Hg. The discharged Hg has not yet impacted on MMHg concentrations in fish or in hair of fish consumers. Hair Hg concentration, used as a biomarker of fish consumption, indicates that the Amazonian riparians are acquiring an excellent source of protein carrying important nutrients, the lack of which could aggravate their existing health problems. Therefore, in a scenario of insufficient health services and an unhealthy environment, food habits based on fish consumption are part of a successful survival strategy and recommendations for changes are not yet justifiable.

Concern and awareness is growing about the health effects of exposures to environmental contaminants, including those found in food. Most primary care physicians lack knowledge and training in the clinical recognition and management of the health effects of environmental exposures. We have found that the use of a simple history-taking tool - the CH2OPD2 mnemonic (Community, Home, Hobbies, Occupation, Personal habits, Diet and Drugs) - can help physicians identify patients at risk of such health effects. We present an illustrative case of a mother who is concerned about eating fish and wild game because her 7-year-old son has been found to have learning difficulties and she is planning another pregnancy. Potential exposures to persistent organic pollutants (POPs) and mercury are considered. The neurodevelopmental effects of POPs on the fetus are reviewed. We provide advice to limit a patient's exposure to these contaminants and discuss the relevance of these exposures to the learning difficulties of the 7-year-old child and to the planning of future pregnancies.

The three modern "faces" of mercury are our perceptions of risk from the exposure of billions of people to methyl mercury in fish, mercury vapor from amalgam tooth fillings, and ethyl mercury in the form of thimerosal added as an antiseptic to widely used vaccines. In this article I review human exposure to and the toxicology of each of these three species of mercury. Mechanisms of action are discussed where possible. Key gaps in our current knowledge are identified from the points of view both of risk assessment and of mechanisms of action.

Several studies in the Amazonian Basin have shown that riverine populations are exposed to methylmercury through fish consumption. It has been suggested that seasonal variations in hair mercury observed through sequential analyses may be related to the changes in fish species ingested by the local communities. The aim of the present study was to investigate the relationship between fish-eating practices and seasonal variation in mercury exposure. A group of 36 women from a village located on the banks of the Tapajós River, a major tributary of the Amazon, comprised the present study population. An interview-administered questionnaire was used to gather information on socio-demographic characteristics, fish-eating practices and other relevant information. The women also provided hair samples of at least 24 cm in length for mercury analysis. Hair total and inorganic mercury concentration was measured using a cold vapor atomic absorption analytical method. Trigonometric regression analysis was done to assess the seasonal variation of total mercury levels. Variations in inorganic mercury were examined by repeated measures analysis of variance, and analysis of contrast variable with a polynomial transformation. The results showed that hair mercury levels varied with the season. Higher levels were observed in months corresponding to the dry season, with lower levels in the rainy season. Herbivorous fish predominated the diet for 47.2% of the women during the dry season, but this rose to 72.2% during the rainy season. Those who reported eating fish daily had higher mercury levels in hair compared to those who only ate fish a few times per week. Retrospective mercury analyses, evaluated by the quantity of mercury present in each centimeter of hair, indicate that mean mercury level of the population decreased over the 2 years prior to the study. The percentage of inorganic mercury over the total mercury in hair increased towards the extremities of the hair strand. Higher percentages of inorganic mercury were found for the group who ate more fish (on a daily consumption basis). These results support the assumption that there are seasonal variations in methylmercury exposure and also a relationship between type of fish species consumed and the resulting hair mercury levels.

Accumulation of a toxic agent (2-4-fold maximum allowable concentrations) was found in the fish caught in the polluted area of the water storage basin of the Angara river. The authors quantified a risk for major pathological syndromes in individuals exposed to mercury on fish ingestion and assayed biosubstrates for the substance. The integral risk of major pathological syndromes in the potentially mercury loaded persons increased by 62.1% with age and only by 17.1% in the control group. In the risk pattern there were risks for neurological diseases, arterial hypertension, coronary heart disease, borderline mental disorders, and endocrine diseases.

Environmental risk-management decisions in the U.S. involving potential exposures to methylmercury currently use a reference dose (RfD) developed by the U.S. Environmental Protection Agency (USEPA). This RfD is based on retrospective studies of an acute poisoning incident in Iraq in which grain contaminated with a methylmercury fungicide was inadvertently used in the baking of bread. The exposures, which were relatively high but lasted only a few months, were associated with neurological effects in both adults (primarily paresthesia) and infants (late walking, late talking, etc.). It is generally believed that the developing fetus represents a particularly sensitive subpopulation for the neurological effects of methylmercury. The USEPA derived an RfD of 0.1 microg/kg/day based on benchmark dose (BMD) modeling of the combined neurological endpoints reported for children exposed in utero. This RfD included an uncertainty factor of 10 to consider human pharmacokinetic variability and database limitations (lack of data on multigeneration effects or possible long-term sequelae of perinatal exposure). Alcoa signed an Administrative Order of Consent for the conduct of a remedial investigation/feasibility study (RI/FS) at their Point Comfort Operations and the adjacent Lavaca Bay in Texas to address the effects of historical discharges of mercury-containing wastewater. In cooperation with the Texas Natural Resource Conservation Commission and USEPA Region VI, Alcoa conducted a baseline risk assessment to assess potential risk to human health and the environment. As a part of this assessment. Alcoa pursued the development of a site-specific RfD for methylmercury to specifically address the potential human health effects associated with the ingestion of contaminated finfish and shellfish from Lavaca Bay. Application of the published USEPA RfD to this site is problematic; while the study underlying the RfD represented acute exposure to relatively high concentrations of methylmercury, the exposures of concern for the Point Comfort site are from the chronic consumption of relatively low concentrations of methylmercury in fish. Since the publication of the USEPA RfD, several analyses of chronic exposure to methylmercury in fish-eating populations have been reported. The purpose of the analysis reported here was to evaluate the possibility of deriving an RfD for methylmercury, specifically for the case of fish ingestion, on the basis of these new studies. In order to better support the risk-management decisions associated with developing a remediation approach for the site in question, the analysis was designed to provide information on the distribution of acceptable ingestion rates across a population, which could reasonably be expected to be consistent with the results of the epidemiological studies of other fish-eating populations. Based on a review of the available literature on the effects of methylmercury, a study conducted with a population in the Seychelles Islands was selected as the critical study for this analysis. The exposures to methylmercury in this population result from chronic, multigenerational ingestion of contaminated fish. This prospective study was carefully conducted and analyzed, included a large cohort of mother-infant pairs, and was relatively free of confounding factors. The results of this study are essentially negative, and a no-observed-adverse-effect level (NOAEL) derived from the estimated exposures has recently been used by the Agency for Toxic Substances and Disease Registry (ATSDR) as the basis for a chronic oral minimal risk level (MRL) for methylmercury. In spite of the fact that no statistically significant effects were observed in this study, the data as reported are suitable for dose-response analysis using the BMD method. Evaluation of the BMD method used in this analysis, as well as in the current USEPA RfD, has demonstrated that the resulting 95% lower bound on the 10% benchmark dose (BMDL) represents a conservative estimate of the traditional NOAEL, and that it is superior to the use of "average" or "grouped" exposure estimates when dose-response information is available, as is the case for the Seychelles study. A more recent study in the Faroe Islands, which did report statistically significant associations between methylmercury exposure and neurological effects, could not be used for dose-response modeling due to inadequate reporting of the data and confounding from co-exposure to polychlorinated biphenyls (PCBs). BMD modeling over the wide range of neurological endpoints reported in the Seychelles study yielded a lowest BMDL for methylmercury in maternal hair of 21 ppm. This BMDL was then converted to an expected distribution of daily ingestion rates across a population using Monte Carlo analysis with a physiologically based pharmacokinetic (PBPK) model to evaluate the impact of interindividual variability. The resulting distribution of ingestion rates at the BMDL had a geometric mean of 1.60 microg/kg/day with a geometric standard deviation of 1.33; the 1st, 5th, and 10th percentiles of the distribution were 0.86, 1.04, and 1.15 microg/kg/day. In place of the use of an uncertainty factor of 3 for pharmacokinetic variability, as is done in the current RfD, one of these lower percentiles of the daily ingestion rate distribution provides a scientifically based, conservative basis for taking into consideration the impact of pharmacokinetic variability across the population. On the other hand, it was felt that an uncertainty factor of 3 for database limitations should be used in the current analysis. Although there can be high confidence in the benchmark-estimated NOAEL of 21 ppm in the Seychelles study, some results in the New Zealand and Faroe Islands studies could be construed to suggest the possibility of effects at maternal hair concentrations below 10 ppm. In addition, while concerns regarding the possibility of chronic sequelae are not supported by the available data, neither can they be absolutely ruled out. The use of an uncertainty factor of 3 is equivalent to using a NOAEL of 7 ppm in maternal hair, which provides additional protection against the possibility that effects could occur at lower concentrations in some populations. Based on the analysis described above, the distribution of acceptable daily ingestion rates (RfDs) recommended to serve as the basis for site-specific risk-management decisions at Alcoa's Point Comfort Operations ranges from approximately 0.3 to 1.1 microg/kg/day, with a population median (50th percentile) of 0.5 microg/kg/day. By analogy with USEPA guidelines for the use of percentiles in applications of distributions in exposure assessments, the 10th percentile provides a reasonably conservative measure. On this basis, a site-specific RfD of 0.4 microg/kg/day is recommended.

Fish consumption is an important source of protein among indigenous communities in Amazonian Brazil. Exposures to mercury via fish were studied in an indigenous community of the Munduruku reserve, located in the Tapajós River basin in the state of Pará, one of the oldest and most productive gold mining areas in the Amazon region. This study summarizes the results of mercury (Hg) analyses of fish consumed by inhabitants of the Munduruku settlement of Sai Cinza. The most frequently consumed fish, reported by 330 persons interviewed for this study, were tucunaré, pacu, jaraqui, traíra, aracu, matrinchã, and caratinga. The mean mercury concentration in carnivorous fish was 0.297 microg.g(-1) while in noncarnivorous fish mean mercury concentration was 0.095 microg.g(-1). Only in caratinga was there a significant relationship between fish size, weight, and mercury levels. Levels of methylmercury in the tucunaré averaged 0.170 microg.g(-1), while in traíra the mean level of methylmercury was 0.212 microg.g(-1). Although the levels of Hg in fish consumed by the Sai Cinza community are below the Brazilian limit value for consumption, the high rates and amounts of fish consumed by this population are relevant to evaluating risks of mercury contamination for communities with limited food resources., (Copyright 2000 Academic Press.)

Risks associated with toxicants in food are often controlled by exposure reduction. When exposure recommendations are developed for foods with both harmful and beneficial qualities, however, they must balance the associated risks and benefits to maximize public health. Although quantitative methods are commonly used to evaluate health risks, such methods have not been generally applied to evaluating the health benefits associated with environmental exposures. A quantitative method for risk-benefit analysis is presented that allows for consideration of diverse health endpoints that differ in their impact (i.e., duration and severity) using dose-response modeling weighted by quality-adjusted life years saved. To demonstrate the usefulness of this method, the risks and benefits of fish consumption are evaluated using a single health risk and health benefit endpoint. Benefits are defined as the decrease in myocardial infarction mortality resulting from fish consumption, and risks are defined as the increase in neurodevelopmental delay (i.e., talking) resulting from prenatal methylmercury exposure. Fish consumption rates are based on information from Washington State. Using the proposed framework, the net health impact of eating fish is estimated in either a whole population or a population consisting of women of childbearing age and their children. It is demonstrated that across a range of fish methylmercury concentrations (0-1 ppm) and intake levels (0-25 g/day), individuals would have to weight the neurodevelopmental effects 6 times more (in the whole population) or 250 times less (among women of child-bearing age and their children) than the myocardial infarction benefits in order to be ambivalent about whether or not to consume fish. These methods can be generalized to evaluate the merits of other public health and risk management programs that involve trade-offs between risks and benefits.

Methylmercury (MeHg) is a potent neurotoxin that in high exposures can cause mental retardation, cerebral palsy, and seizures. The developing brain appears particularly sensitive to MeHg. Exposure levels in pregnant experimental animals that do not result in detectable signs or symptoms in the mother can adversely affect the offspring's development. Studies of human poisonings suggest this may also occur in humans. Human exposure to MeHg is primarily dietary through the consumption of fish: MeHg is present in all fresh and saltwater fish. Populations that depend on fish as a major source of dietary protein may achieve MeHg exposure levels hypothesized to adversely affect brain development. Increasing mercury levels in the environment have heightened concerns about dietary exposure and a possible role for MeHg in developmental disabilities. Follow-up studies of an outbreak of MeHg poisoning in Iraq revealed a dose-response relationship for prenatal MeHg exposure. That relationship suggested that prenatal exposure as low as 10 ppm (measured in maternal hair growing during pregnancy) could adversely affect fetal brain development. However, using the same end points as were used in the Iraq study, no associations have been reported in fish-eating populations. Using a more extensive range of developmental end points, some studies of populations consuming seafood have reported associations with prenatal MeHg exposure, whereas others have found none. This paper reviews the data presently available associating MeHg exposure with development and poses some of the unanswered questions in this field.

Methyl mercury (meHg) contamination of fish is the leading cause of fish consumption advisories in the United States. These advisories have focused upon repeated or chronic exposure, whereas risks during pregnancy may also exist from a single-meal exposure if the fish tissue concentration is high enough. In this study, acute exposure to meHg from a single fish meal was analyzed by using the one-compartment meHg biokinetic model to predict maternal hair concentrations. These concentrations were evaluated against the mercury hair concentration corresponding to the U.S. Environmental Protection Agency's reference dose (RfD), which is intended to protect against neurodevelopmental effects. The one-compartment model was validated against blood concentrations from three datasets in which human subjects ingested meHg in fish, either as a single meal or multiple meals. Model simulations of the single-meal scenario at different fish meHg concentrations found that concentrations of 2.0 ppm or higher can be associated with maternal hair concentrations elevated above the RfD level for days to weeks during gestation. A single-meal fish concentration cutoff of > or = 2.0 ppm is an important consideration, especially because this single high exposure event might be in addition to a baseline meHg body burden from other types of fish consumption. This type of single-meal advisory requires that fish sampling programs provide data for individual rather than composited fish, and take into account seasonal differences that may exist in fish concentrations.

The present study aimed to evaluate methylmercury in fish and human hair samples from an important hydroelectrical reservoir, Balbina (Brazil, Amazon). It presents a quite intense fishing activity and there is no known goldmining activity in its watershed. Fish and human hair were analyzed with a new extraction technique and measured by GC-ECD. Analytical quality was checked through intercomparisons between two laboratories with local samples and certified standards from IAEA. Methylmercury in hair ranged from 2.0 to 21.6 microg . g-1 with a mean of 8.76+/-5.20 microg . g-1 (N=20), while the methylmercury percentages were above 90. Fish presented methylmercury levels ranging from 0.03 to 0.9 microg small middle dot g-1 wet wt with a mean of 0.24+/-0.18 microg small middle dot g-1 wet wt (N=32), which is below the limit established for food by Brazilian legislation (0.5 microg small middle dot g-1 wet wt) and methylmercury mean percentages were above 95%. The total mean daily methylmercury intake ranged from 11 to 55 microg for 70% of the sampled population from the village based on a daily consumption of about 110 g of fish with methylmercury concentrations in the range of 0.1 to 0.5 microg . g-1. This calculation is consistent with methylmercury concentrations in hair samples in the range of 2.6 to 13.1 microg . g-1., (Copyright 1998 Academic Press.)

The New York State Angler Study will evaluate the association between past and current consumption of contaminated fish from Lake Ontario and both short- and long-term health effects in a population-based cohort. It will measure fish consumption and reproductive and developmental health among 10,518 male anglers and 6,651 of their wives or partners, as well as among 913 female anglers. To characterize exposure among subgroups of the cohort, further analytical methods were developed and implemented to measure specific polychlorinated biphenyls (PCB) congeners, methylmercury, and other substances in biological samples. Exposure assessment has been completed for a stratified random sample of 321 anglers. In addition, analyses for 79 congeners of PCBs are complete for 177 anglers. A special study of duck and turtle consumers currently is underway. Telephone interviews have been completed with 2,454 of the 2,999 women who planned a pregnancy between 1991 and 1994. The entire cohort of male anglers, partners of male anglers, and female anglers has been submitted for matching with the New York State live birth and fetal death registries to obtain lifetime reproductive histories. A medical record abstraction study will assess perinatal and developmental outcomes among the 3,442 births that occurred between 1986 and 1991. Finally, a study of breast milk from currently lactating women is underway, and 215 breast milk samples have been collected from the planned pregnancy subcohort. Progress on each of the study components is discussed herein.

Aquatic food chain mercury pollution is one of the consequences of the gold rush in the Amazon, which started in the late 1970s. This paper addresses the risks of methylmercury (MeHg) toxicity by a riverside population of heavy fish eaters along the Madeira river, in the Amazon, based on their hair mercury (Hg) concentration. Given the vulnerability of the developing nervous system, NOEL/LOEL values were used based on prenatal (LOELp = 0.7 microgram/ kg bw), and adult and childhood (LOELa = 3 micrograms/kg bw) Hg exposures. Based on hair Hg concentrations, we observed that approximately 95% of infants were at risk of absorbing Hg through the previous placental exposure, and/or by ingesting Hg from mother's milk, and/or fish consumption, at a level as great as the LOELp. The hazard quotient derived from the LOELp for neurobehavioral effects was 64 based on an estimated mean Hg daily intake of 4.5 micrograms/kg bw. Approximately 45% of the mothers of the infants and other women of child bearing age were at risk of ingesting Hg at a level equivalent to the LOELp. This also translates into a derived hazard quotient for neurobehavioral effects of 17 for all potential mothers in the population. The non-infant population at the highest risk was fish-eating children under 5 years old. This sub-population had a mean estimated Hg daily intake of 6.4 micrograms/kg bw. This resulted in a probability that almost 60% of this sub-population ingested Hg at a level equivalent to the LOELa or higher. For this sub-population, there was a hazard quotient of 21. These data strongly indicate that the young children of this riverside fish-eating population may be ingesting Hg doses that have been correlated with neurological damage from Hg poisoning.

Lack of demonstrated neurotoxicity among fish-eating populations has been cited by the World Health Organization and others as supporting an adult LOEL (lowest observed effect level) of > or = 200 ppb blood mercury equivalent. We reviewed 13 published evaluations of neurologic status as related to tissue mercury or methylmercury concentration in long-term fish-eating populations. Review criteria included study size, design (sampling strategy, characterization of exposure, characterization of outcome) and data analysis. No case of classic Minimata disease is described in the 13 studies. Also, no study clearly shows a threshold tissue level above which any form of neurologic dysfunction occurs. A study by Valciukas et al. shows no evidence of neurologic impairment in groups with blood mercury of 10-20 ppb. Studies by Spitzer et al. and McKeown-Eyssen and Reudy suggest correlation of neurologic dysfunction with rising blood mercury concentrations in the 60-120 ppb range. While other studies show no effects associated with rising mercury dose, numbers are small, participant self-selection likely and the clinical assessment limited. Together the 13 studies describe neurologic examinations in approximately 50 fish eaters having a blood mercury equivalent above 200 ppb; of these subjects, neurologic dysfunction consistent with methylmercury exposure was found in as few as six and as many as 15. We conclude that the oft-cited LOEL for (methyl)mercury of 200 ppb in blood is not supported by these studies.