Jean Rémy Davée Guimarães

A preliminary study of mercury exposure and blood pressure in the Brazilian Amazon

BackgroundFish is considered protective for coronary heart disease (CHD), but mercury (Hg) intake from fish may counterbalance beneficial effects. Although neurotoxic effects of methylmercury (MeHg) are well established, cardiovascular effects are still debated. The objective of the present study was to evaluate blood pressure in relation to Hg exposure and fish consumption among a non-indigenous fish-eating population in the Brazilian Amazon.MethodsThe study was conducted among 251 persons from six communities along the Tapajós River, a major tributary of the Amazon. Data was obtained for socio-demographic information, fish consumption, height and weight to determine body mass index (BMI), systolic and diastolic blood pressure, and Hg concentration in hair samples.ResultsResults showed that overall, systolic and diastolic blood pressure, were relatively low (mean: 113.9 mmHg ± 14.6 and 73.7 mmHg ± 11.0). Blood pressure was significantly associated with hair total Hg (H-Hg), age, BMI and gender. No association was observed between fish consumption and blood pressure, although there were significant inter-community differences. Logistic regression analyses showed that the Odds Ratio (OR) for elevated systolic blood pressure (≥ 130 mmHg) with H-Hg ≥ 10 μg/g was 2.91 [1.26–7.28], taking into account age, BMI, smoking, gender and community.ConclusionThe findings of this preliminary study add further support for Hg cardiovascular toxicity.

Selenium and mercury in the Brazilian Amazon : opposing influences on age-related cataracts

Background Age-related cataracts (ARCs) are an important cause of blindness in developing countries. Although antioxidants may be part of the body’s defense to prevent ARC, environmental contaminants may contribute to cataractogenesis. In fish-eating populations of the lower Tapajós region, elevated exposure to mercury (Hg) has been reported, and blood levels of selenium (Se) range from normal to very high (> 1,000 μg/L). Objectives We examined ARCs in relation to these elements among adults (≥ 40 years of age) from 12 riverside communities. Methods Participants (n = 211) provided blood samples and underwent an extensive ocular examination. Inductively coupled plasma mass spectrometry was used to assess Hg and Se in blood and plasma. Results One-third (n = 69; 32.7%) of the participants had ARC. Lower plasma Se (P-Se; < 25th percentile, 110 μg/L) and higher blood Hg (B-Hg; ≥ 25th percentile, 25 μg/L) were associated with a higher prevalence odds ratio (POR) of ARC [adjusted POR (95% confidence interval), 2.69 (1.11–6.56) and 4.45 (1.43–13.83), respectively]. Among participants with high P-Se, we observed a positive but nonsignificant association with high B-Hg exposure, whereas among those with low B-Hg, we observed no association for P-Se. However, compared with the optimum situation (high P-Se, low B-Hg), the POR for those with low P-Se and high B-Hg was 16.4 (3.0–87.9). This finding suggests a synergistic effect. Conclusion Our results suggest that persons in this population with elevated Hg, the cataractogenic effects of Hg may be offset by Se. Because of the relatively small sample size and possible confounding by other dietary nutrients, additional studies with sufficient power to assess multiple nutrient and toxic interactions are required to confirm these findings.

Selenium from dietary sources and motor functions in the Brazilian Amazon

Selenium (Se) is a well-known anti-oxidant with a critical role in the proper functioning of nervous and muscle functions. Se deficiency has been associated with both cognitive and neuromotor impairment, while sensory and motor deficits have been attributed to excess Se. In the Lower Tapajós Region of the Brazilian Amazon, riverside populations present a wide range of Se levels. These fish-eating communities have among the highest mercury (Hg) exposures reported in the world today, and recently, lead (Pb) exposure has been identified. Some studies suggest that Se intake can be protective for Hg and/or Pb toxicity, however, data from animal and human studies are inconsistent. The objective of the present study was to examine the relations between biomarkers of Se and motor functions, taking into account co-variables and biomarkers of exposure to Hg and Pb. Participants (n=448), aged 15-87 y, were recruited from 12 communities along the Tapajós River. Se concentrations were measured in whole blood (B-Se), plasma (P-Se), hair (H-Se) and urine (U-Se) by ICP-MS. Whole blood Hg (B-Hg) and Pb (B-Pb) were also measured by ICP-MS. Interview-administered questionnaires served to collect information on socio-demographics and medical history. All participants underwent a complete visual examination and performed tests of motor functions (Branches Alternate Movement Task, Santa Ana Test, Dynamometer and Grooved Pegboard Test). B-Se varied from 103 to 1500 μg/L (median 228 μg/L), P-Se from 53.6 to 913 μg/L (median 135 μg/L), H-Se from 0.4 to 3.8 μg/g (median 0.7 μg/g) and U-Se from 2.3 to 1375 μg/g cr. (median 33.6 μg/g cr.). Median B-Hg and B-Pb levels were 42.5 μg/L and 113 μg/L respectively. In multivariable analysis, Se biomarkers (log-transformed) were positively related to better performance on all motor tests, taking into account socio-demographic co-variables and B-Hg and B-Pb levels. P-Se consistently showed stronger associations to motor performance compared to the other Se biomarkers. Regression estimates for Se biomarkers were considerably stronger when controlling for B-Hg. When stratifying at the median for B-Hg concentrations, P-Se consistently presented associations with the outcomes only at high B-Hg concentrations. This is the first human study to report beneficial effects of high Se status on motor functions. For this population with elevated Hg exposure, high dietary Se intake may be critical for brain and muscle functions. However, these findings are not necessarily applicable to populations with lower Hg exposure and/or Se status, which is the case for people who do not rely heavily on fish consumption, be they in Brazil, the United States or elsewhere. The associations were mostly observed with P-Se, suggesting that P-Se or plasma selenoproteins may be good biomarkers for these outcomes.

Transfer of mercury and methylmercury along macroinvertebrate food chains in a floodplain lake of the Beni River, Bolivian Amazonia.

We have evaluated the mercury and methylmercury transfers to and within the macroinvertebrate communities of a floodplain lake of the Beni River basin, Bolivia, during three hydrological seasons and in two habitats (open water and vegetation belt). Using the stable isotopes delta(13)C and delta(15)N, six trophic chains were identified during a previous study. Four are based on only one source: seston, organic matter from the bottom sediment, periphyton and macrophytes. Two are based on mixed sources (seston and periphyton in one case, periphyton and macrophytes in the other). During sampling, we found only one taxon that had surface sediment organic matter as food source and very few taxa whose trophic source was constituted by macrophytes. The periphyton was the most important source during all seasons; it produced the longest chain, with three trophic positions. Whatever the season and trophic source, all collected macroinvertebrates contained methyl mercury and the latter was biomagnified in all trophic chains that we identified. The biomagnification of methylmercury through invertebrate trophic chains accurately reflected the existence and length of these chains. Biomagnification was virtually non-existent in the sediment-based chain, low and restricted to the dry season in the macrophyte-based chain. It was significant in the seston-based chain, but limited by the existence of only two trophic levels and restricted to the wet season. Finally, it was very effective in the periphyton-based chain, which offers the highest rate of contamination of the source but, above all, the largest number of trophic levels.

Elevated levels of selenium in the typical diet of Amazonian riverside populations

Selenium (Se) intake is generally from food, whose Se content depends on soil Se and plant accumulation. For humans, adequate Se intake is essential for several selenoenzymes. In the Lower Tapajós region of the Brazilian Amazon, Se status is elevated with large inter-community variability. Se intake in this region, where Hg exposure is among the highest in the world, may be important to counteract mercury (Hg) toxicity. The present study was conducted in 2006 with 155 persons from four communities of the Lower Tapajós. The objectives were: i) to evaluate Se content in their typical diet and drinking water; ii) to compare food Se concentrations with respect to geographic location; and iii) to examine the contribution of consumption of different food items to blood Se. More than 400 local foods and 40 drinking water samples were collected. Participants responded to an interview-administered food frequency questionnaire and provided blood samples. Food, water and blood Se levels were assessed by ICP-MS. Since Brazil nuts may also contain significant levels of barium (Ba) and strontium (Sr), these elements were likewise analyzed in nuts. The highest Se concentrations were found in Brazil nuts, but concentrations were highly variable (median: 13.9 microg/g; range: 0.4-158.4 microg/g). Chicken, game meat, eggs and beef also contained considerable levels of Se, with median concentrations from 0.3 to 1.4 microg/g. There was no particular geographic distribution of food Se. Se concentration in drinking water was very low (< 1.4 microg/L). Blood Se covered a (103-1500 microg/L), and was positively related to regular consumption of Brazil nuts, domestic chicken and game meat. Brazil nuts were found to contain highly variable and often very high concentrations of Ba (88.0 microg/g, 1.9-1437 microg/g) and Sr (38.7 microg/g, 3.3-173 microg/g).

No evidence of selenosis from a selenium-rich diet in the Brazilian Amazon

Selenium (Se) is an essential element and a well-known anti-oxidant. In the Lower Tapajós River region of the Brazilian Amazon, biomarkers of Se range from normal to very high. The local traditional diet includes important Se sources such as Brazil nuts, chicken, game meat and certain fish species. Some studies have reported alterations in keratin structure, gastrointestinal problems and paresthesia in populations with high Se intake. The objective of the present study was to evaluate cutaneous and garlic odor of the breath signs and sentinel symptoms of Se toxicity (selenosis) in relation to Se status in communities along the Tapajós River. Participants (N=448), aged 15-87 years, were recruited from 12 communities. Se concentrations were measured in blood (B-Se) and plasma (P-Se) by ICP-MS. A nurse performed an examination of the hair, nails, skin and breath for signs of Se toxicity. Interview-administered questionnaires were used to collect information on socio-demographics, medical history and possible symptoms of Se toxicity. In this population, the median levels of B-Se and P-Se were 228.4 μg/L (range 103.3-1500.2 μg/L) and 134.8 μg/L (range 53.6-913.2 μg/L) respectively. Although B-Se and P-Se surpassed concentrations considered toxic (B-Se: 1000 μg/L (U.S. EPA, 2002)), no dermal or breath signs or symptoms of Se toxicity were associated with the biomarkers of Se status. In the present study population, where Se intake is mostly from traditional diet, there is no evidence of selenosis. These findings support the need to re-assess Se toxicity considering factors such as the chemical form of Se exposure, route of exposure (inhaled versus ingested), co-exposures to toxic elements such as mercury. Considering the current food transition towards a western diet in the Amazon, further studies should address the possible association between high Se status and cardiometabolic health in this study population.

Elevated blood lead levels in a riverside population in the Brazilian Amazon.

Lead (Pb) is recognized as one of the most toxic metals. Sources of Pb exposure have been widely documented in North America, and the removal of Pb additives from gasoline was reflected in a dramatic lowering of blood Pb concentration. In Latin America, the removal of Pb from gasoline resulted in decreased exposure, but Pb levels in many areas remain high due to occupational and environmental sources of exposure. While many of the Pb sources have been identified (mining, industries, battery recycling, lead-based paint, ceramics), new ones occasionally crop up. Here we report on blood Pb (B-Pb) levels in remote riverside communities of the Brazilian Amazon. Blood Pb (B-Pb) levels were determined in 448 persons from 12 villages of the Lower Tapajós River Basin, Pará, Brazil. Socio-demographic and dietary information, as well as occupational, residential and medical history was collected using an interview-administered questionnaire. B-Pb, measured by ICP-MS, showed elevated concentrations. Mean B-Pb was 13.1 microg/dL +/- 8.5, median B-Pb was 11.2 microg/dL and ranged from 0.59 to 48.3 microg/dL. Men had higher B-Pb compared to women (median: 15.3 microg/dL vs 7.9 microg/dL respectively). B-Pb increased with age for women, while it decreased for men. For both genders, B-Pb decreased with education. There were significant differences between villages. Exploratory analyses, using linear partition models, showed that for men B-Pb was lower among those who were involved in cattle-raising, and higher among those who hunted, farmed and fished. The distribution profile of B-Pb directed us towards artisanal transformation of manioc to flour (farinha), which requires heating in a large metal pan, with stirring primarily done by young men. In the village with the highest B-Pb, analysis of Pb concentrations (dry weight) of manioc (prior to transformation) and farinha (following transformation) from 6 houses showed a tenfold increase in Pb concentration (mean: 0.017 +/- 0.016 to 0.19 +/- 0.10 microg/g). This was confirmed in one of these villages where we sampled manioc paste (just before roasting) and the roasted farinha (0.05 microg/g vs 0.20 microg/g). While there may be other sources (ammunition, sinkers for fishing nets), the high concentrations in farinha, a dietary staple, assuredly makes an important contribution. Further action needs to reduce Pb sources in this region.

Mercury bioaccumulation patterns in fish from the Iténez river basin, Bolivian Amazon.

The bioaccumulation mechanism expresses an increment of mercury concentration along the lifetime of each individual. It is generally investigated along the age or size range of organisms from a same population. Water chemistry and trophic position are important factors that may influence the emergence of bioaccumulation patterns. In order to detect the influence of these parameters on fish mercury bioaccumulation patterns, we explored the relations between mercury concentration, size and isotopic trophic position of fish populations of six species (three non piscivorous and three piscivorous) in three rivers of the Iténez basin (Bolivia) with different sediment load in water and anthropogenic impact. Fishes of the Iténez basin showed fairly lower mercury contamination in relation to the regional context. They presented lower total mercury concentrations in unperturbed clear water river (average of 0.051 μg g(-1) for non piscivores; 0.088 μg g(-1) for piscivores), intermediate values (average of 0.05 and 0.104 μg g(-1)) in unperturbed white water river, whereas the highest values (average of 0.062 and 0.194 μg g(-1)) were found in the perturbed clear water river. Piscivore and invertivore species showed significant positive bioaccumulation patterns in the perturbed river and in the unperturbed white water river. No positive pattern was detected in the unperturbed clear water river. Positive patterns could not be attributed to differences in trophic condition and mean fish mercury concentration between populations. Bioaccumulation seems not to be the main factor to explain increased mercury concentrations in fish from the perturbed river.

Visual acuity in fish consumers of the Brazilian Amazon: risks and benefits from local diet

OBJECTIVE To examine the associations between near and distant visual acuity and biomarkers of Hg, Pb, n-3 fatty acids and Se from the local diet of fish-eating communities of the Tapajós River in the Brazilian Amazon. DESIGN Visuo-ocular health and biomarkers of Hg (hair, whole blood, plasma), Pb (whole blood), Se (whole blood and plasma) and n-3 fatty acids (plasma total phospholipids) were assessed in a cross-sectional study. SETTING Lower Tapajós River Basin (State of Pará, Brazil), May to July 2006. SUBJECTS Two hundred and forty-three adults (≥15 years) without diagnosed age-related cataracts or ocular pathologies. RESULTS Near visual acuity was negatively associated with hair Hg and positively associated with %DHA, with a highly significant Log Hg × age interaction term. Stratifying for age showed that while young people presented good acuity, for those aged ≥40 years, clinical presbyopia was associated with hair Hg ≥ 15 μg/g (OR = 3·93, 95% CI 1·25, 14·18) and %DHA (OR = 0·37, 95% CI 0·11, 1·11). A similar age-related pattern was observed for distant visual acuity in relation to blood Pb, but the evidence was weaker. CONCLUSIONS These findings suggest that Hg and Pb may affect visual acuity in older persons, while DHA appears to be protective for near visual acuity loss. In this population, with little access to eye care, diet may have an important influence on visuo-ocular ageing.

Quality of life and health perceptions among fish-eating communities of the Brazilian Amazon : an ecosystem approach to well-being

Mercury (Hg) contamination in the Brazilian Amazon constitutes a serious environmental and public health issue. This study is part of the CARUSO Project, which uses an ecosystem approach to human health to examine the sources, transmission, and effects of Hg in the Brazilian Amazon, with a view to developing preventive intervention strategy. To date, studies have focused on measures of Hg exposure through fish consumption in relation to health effects; little attention has been given to quality of life (QoL). The objective of this study was to examine the relations between QoL and health perceptions, Hg exposure, sociodemographics, living conditions, and lifestyle in communities along the Tapajós River. A total of 456 adults from 13 villages were interviewed and provided hair samples for Hg analysis. Results showed that perceptions of QoL and health are relatively positive, despite elevated Hg exposure. Logistic regression analyses showed that a positive perception of QoL was associated with the absence of chronic illnesses, not smoking, fruit consumption, residing on the banks of the Tapajós, and living in an in-migrants’ community. The positive perception of health was associated with younger age, the absence of reported symptoms of chronic illnesses, and drinking alcoholic beverages. Cluster analysis revealed that the group that reported the highest QoL had a traditional lifestyle, involving daily fishing and high fish consumption. However, this traditional lifestyle is associated with elevated Hg levels and early reported symptoms potentially linked to Hg exposure. These findings underline the importance of understanding the factors underlying QoL to develop adequate strategies to reduce Hg exposure and promote well-being.