Eric J Buenz

Consumption of wild-harvested meat from New Zealand feral animals provides a unique opportunity to study the health effects of lead exposure in hunters

There are numerous reasons for countries to transition to non-lead ammunition as highlighted by Kanstrup et al. (2016). When wild game animals are killed with lead projectiles, hundreds of lead fragments are dispersed throughout the carcass and packages of processed wild game are reported to contain lead fragments (Hunt et al. 2009). There is also a correlation between subsistence hunters using lead projectiles and elevated levels of lead in the blood (Tsuji et al. 2008; Iqbal et al. 2009; Fachehoun et al. 2015). Since there is no safe level of lead exposure (Canfield et al. 2003; WHO 2009), this lead exposure through hunting may be a significant public health concern and one that is avoidable (Buenz 2016). Furthermore, many hunters are unaware of the potential risks of lead in wildgame meat or hold unyielding opinions that lead projectiles do not pose a health risk. However, we are all aware that a correlation does not imply causality, and there has yet to be a conclusive interventional study establishing if there are increased levels of lead exposure due to eating wild game harvested with lead bullets or shot. We hypothesize that eating wild game harvested with lead bullets results in increased blood lead levels for hunters and their family members. This hypothesis can be tested through an interventional trial in New Zealand by providing hunters with lead-free or standard lead projectiles and measuring blood lead levels after hunters and their families eat wild game. New Zealand is the ideal location for this study because all wild game species are feral, without a restricted hunting season. When Captain Cook arrived in New Zealand in 1773, his crew released the first pigs and goats into an environment that previously had supported only a limited range of highly endemic fauna, almost exclusively birds. Multiple subsequent animal liberations also occurred throughout the islands of New Zealand to provide a food source for potential castaways. Additionally, other species, especifically multiple types of deer, tahr, and chamois, were introduced to foster game hunting. As a result of these introductions, New Zealand has at least 14 species of feral ungulates. The modern New Zealand Department of Conservation is tasked with either managing or exterminating these feral species: this effort goes as far as aerially deploying more of the pesticide sodium fluoroacetate (i.e., 1080) than anywhere else in the world. In a similar effort, New Zealand is the only place in the world with licensefree, year round, wild game hunting (Kerr and Abell 2014). In contrast, in the United States and Europe, the hunting season lasts for only weeks or months. This unique hunting situation allows hunters in New Zealand to harvest more wild game, more regularly, for food. We propose a two-year blinded study randomizing hunters to groups harvesting animals with lead projectiles and lead-free projectiles. Specifically, after a run-in period and baseline blood lead-level assessment, hunters would be given lead or lead-free bullets and asked to harvest and process their deer. Within the lead pharmacokinetic peak of 2–4 days after ingesting lead (Hunt et al. 2009), hunters and their families would be asked to provide blood and urine samples for lead-level measurement and report the location where the game eaten was harvested. Since individual hunters tend to harvest game from a specific geographic area, a crossover study design would be possible, with hunters switching to the other projectile type after 1 year. Since following exposure to lead there is a temporal

The Ethnopharmacologic Contribution to Bioprospecting Natural Products

Descriptions of the use of natural products in traditional medicine have served as starting points for new therapeutics. The details of the traditional use of these organisms can provide important information for future drug discovery and development efforts. Recent technologic advances provide the framework to leverage ethnopharmacologic data in the drug discovery process. Information on the traditional harvest, preparation, storage, and administration of the organisms, and the natural products they contain, provides valuable details regarding characteristics of the active compounds. Importantly, researchers can now rapidly analyze and identify the multiple, and often synergistic, compounds contained in these natural products. Although we are entering the acme of ethnopharmacology, where information regarding the traditional use of organisms can provide valuable natural product leads and accelerate the identification of new therapeutics, this ethnopharmacologic resource is threatened by the loss of traditional medicine knowledge and extinction of organisms.

Non-lead ammunition may reduce lead levels in wild game

Lehel et al. (2016) provide important data regarding the levels of toxic metals in deer meat. As the authors highlight, there is reason for concern regarding lead levels in wild game relative to the European Union standards. Some of this lead exposure is inevitable as the source is environmental; however, some is anthropogenic and avoidable. The authors did not share that a portion of this anthropogenic lead exposure is likely preventable by using non-lead ammunition to harvest the wild game (Buenz 2016). Other studies have shown that individuals harvesting wild game with lead bullets have elevated blood lead levels, and isotopeanalyseshave linkedbullets to theseelevatedblood lead levels (Tsuji et al. 2009; Tsuji et al. 2008). Importantly, all the studies to date have established correlations, and a prospective study isnecessary.Nonetheless,weshouldbepragmatic. Justas the parachute has never been proven to be effective in a doubleblind placebo-controlled study (Smith andPell 2003), I suggest that high-velocity injection and fragmentation (Knott et al. 2010) of a heavymetal into something that is going to be eaten is unwise and should be avoided if possible. The World Health Organization has taken the position that there is no safe level of lead exposure (WHO 2009). Thus, any steps available to reduce the potential risk of lead exposure are reasonable to implement, particularly when non-lead ammunition is readily available (Kanstrup et al. 2016). References

A prospective observational study assessing the feasibility of measuring blood lead levels in New Zealand hunters eating meat harvested with lead projectiles

There is no safe level of lead exposure. Correlations suggest that hunters harvesting wild game with lead bullets may be at risk of lead exposure through eating minute lead particles from shrapnel in their wild game. This feasibility study will determine if it is possible to conduct an interventional controlled, blinded study to evaluate if there is a causal relationship between meat harvested with lead bullets and elevated blood lead levels in those who consume the meat. This is an observational case crossover study and the primary outcome is blood lead levels. Individuals will have blood lead levels measured 2–4 days after eating one serving of meat harvested with lead bullets. At three potential washout periods these same individuals will have a subsequent blood lead level analysis. This observational study will provide the data necessary to determine the washout period and sample size for a prospective interventional study to evaluate if meat harvested with lead bullets raises blood-lead levels in those who consume the meat. This study has been approved by the Health and Disabilities Ethics Committees of New Zealand. Trial registration NCT02775890.

A potential therapeutic for chronic pain from the new zealand native stinging nettle urtica ferox (ongaonga)

Objectives Contact with Urtica ferox (ongaonga) causes an intense pain with subsequent sustained numbness. While all factors responsible for the initial painful response are known, the compound(s) responsible for the sustained numbness remain unidentified. There is a need for new therapeutics to treat chronic pain and the yet-to-be identified compounds in Urtica ferox may provide a novel topical treatment for chronic pain. Methods A collection expedition in Kahurangi National Park, New Zealand, was conducted. Urtica ferox trichomes were collected and a water extraction performed. Primary hippocampal neurons and NT2 cells were treated with extract to characterise toxicity. A small animal model was used to assess functional response to extract exposure. Results The extract of Urtica ferox induces a dose-dependent selective toxicity to neurons with morphologic characteristics of apoptosis. Evaluation of extract exposure in the small animal model suggest a direct and specific, effect on neurons. Preliminary characterisation of the active compound indicates a relatively small entity with phenolic ring structure. Conclusions Initial evaluations of the Urtica ferox extract indicate the presence of a compound(s) with promising characteristics. Specifically, a compound that selectively effects neurons that is small and water soluble. This unidentified compound will be characterised using metabolomics.

Heads in the sand: public health and ecological risks of lead-based bullets for wildlife shooting in Australia

Abstract. Lead (Pb) is a toxic element banned from fuel, paint and many other products in most developed countries. Nonetheless, it is still widely used in ammunition, including rifle bullets, and Pb-based bullets are almost universally used in Australia. For decades, poisoning from Pb shot (shotguns) has been recognised as a cause of disease in waterfowl and Pb shot has been subsequently banned for waterfowl hunting in many jurisdictions. However, the risks posed by Pb-based bullets (rifles) have not been similarly recognised in Australia. Pb-based rifle bullets frequently fragment, contaminating the tissue of shot animals. Consuming this Pb-contaminated tissue risks harmful Pb exposure and, thus, the health of wildlife scavengers (carrion eaters) and humans and their companion animals who consume harvested meat (game eaters). In Europe, North America and elsewhere, the environmental and human health risks of Pb-based bullets are widely recognised, and non-toxic alternatives (e.g. copper-based bullets) are increasingly being used. However, Australia has no comparable research despite widespread use of shooting, common scavenging by potentially susceptible wildlife species, and people regularly consuming shot meat. We conclude that Australia has its collective ‘head in the sand’ on this pressing worldwide One Health issue. We present the need for urgent research into this field in Australia.

A potential 40% cost savings through treating cidp with tpe instead of ivig

Objectives CIDP is an inflammatory neuropathy with a prevalence of ~3/100 000. In most countries, CIDP is first treated with IVIg; long term maintenance therapy is usually necessary and the recommended dose is 1 gm/kg every 3 weeks. Therapeutic plasma exchange (TPE) is equally effective to IVIg in a number of diseases. A typical TPE maintenance schedule is 2 days every 3 weeks. TPE and IVIg in NZ are provided by the NZ Blood Service to district health boards (DHB’s); the cost is standardised throughout the country. Our objective was to determine which treatment was more cost-effective for DHB’s. Methods NZBS provided the cost of IVIg and TPE in NZ to the DHBs, including replacement fluids, based on 2016 charges. We assumed a IVIg maintenance schedule of 1 gm/kg every 3 weeks or 2 TPE procedures every 3 weeks. Results Using reported prevalence, there are ~140 patients with CIDP in NZ. The cost to DHB’s per year would have been NZ

Potential role of high-stress employment in hypertension

119 680 per patient or NZ

Lead Exposure Through Eating Wild Game.

16.76 million if all patients had been treated with IVIg for the entire year. The cost of treating those patients with TPE would have been NZ

Chronic Lead Intoxication From Eating Wild-Harvested Game

68 564 per patient or NZ