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      Adverse Effects of Methylmercury: Environmental Health Research Implications

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          Abstract

          Background

          The scientific discoveries of health risks resulting from methylmercury exposure began in 1865 describing ataxia, dysarthria, constriction of visual fields, impaired hearing, and sensory disturbance as symptoms of fatal methylmercury poisoning.

          Objective

          Our aim was to examine how knowledge and consensus on methylmercury toxicity have developed in order to identify problems of wider concern in research.

          Data sources and extraction

          We tracked key publications that reflected new insights into human methylmercury toxicity. From this evidence, we identified possible caveats of potential significance for environmental health research in general.

          Synthesis

          At first, methylmercury research was impaired by inappropriate attention to narrow case definitions and uncertain chemical speciation. It also ignored the link between ecotoxicity and human toxicity. As a result, serious delays affected the recognition of methylmercury as a cause of serious human poisonings in Minamata, Japan. Developmental neurotoxicity was first reported in 1952, but despite accumulating evidence, the vulnerability of the developing nervous system was not taken into account in risk assessment internationally until approximately 50 years later. Imprecision in exposure assessment and other forms of uncertainty tended to cause an underestimation of methylmercury toxicity and repeatedly led to calls for more research rather than prevention.

          Conclusions

          Coupled with legal and political rigidity that demanded convincing documentation before considering prevention and compensation, types of uncertainty that are common in environmental research delayed the scientific consensus and were used as an excuse for deferring corrective action. Symptoms of methylmercury toxicity, such as tunnel vision, forgetfulness, and lack of coordination, also seemed to affect environmental health research and its interpretation.

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          Most cited references52

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          Deficits in Psychologic and Classroom Performance of Children with Elevated Dentine Lead Levels

          To measure the neuropsychologic effects of unidentified childhood exposure to lead, the performance of 58 children with high and 100 with low dentine lead levels was compared. Children with lead levels scored significantly less well on the Wechsler Intelligence Scale for Children (Revised) than those with low lead levels. This difference was also apparent on verbal subtests, on three other measures of auditory or speech processing and on a measure of attention. Analysis of variance showed that none of these differences could be explained by any of the 39 other variables studied. Also evaluated by a teachers' questionnaire was the classroom behavior of all children (2146 in number) whose teeth were analyzed. The frequency of non-adaptive classroom behavior increased in a dose-related fashion to dentine lead level. Lead exposure, at doses below those producing symptoms severe enough to be diagnosed clinically, appears to be associated with neuropsychologic deficits that may interfere with classroom performance.
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            Cognitive deficit in 7-year-old children with prenatal exposure to methylmercury.

            A cohort of 1022 consecutive singleton births was generated during 1986-1987 in the Faroe Islands. Increased methylmercury exposure from maternal consumption of pilot whale meat was indicated by mercury concentrations in cord blood and maternal hair. At approximately 7 years of age, 917 of the children underwent detailed neurobehavioral examination. Neuropsychological tests included Finger Tapping; Hand-Eye Coordination; reaction time on a Continuous Performance Test; Wechsler Intelligence Scale for Children-Revised Digit Spans, Similarities, and Block Designs; Bender Visual Motor Gestalt Test; Boston Naming Test; and California Verbal Learning Test (Children). Clinical examination and neurophysiological testing did not reveal any clear-cut mercury-related abnormalities. However, mercury-related neuropsychological dysfunctions were most pronounced in the domains of language, attention, and memory, and to a lesser extent in visuospatial and motor functions. These associations remained after adjustment for covariates and after exclusion of children with maternal hair mercury concentrations above 10 microgram(s) (50 nmol/g). The effects on brain function associated with prenatal methylmercury exposure therefore appear widespread, and early dysfunction is detectable at exposure levels currently considered safe.
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              Maternal fish intake during pregnancy, blood mercury levels, and child cognition at age 3 years in a US cohort.

              The balance of contaminant risk and nutritional benefit from maternal prenatal fish consumption for child cognitive development is not known. Using data from a prospective cohort study of 341 mother-child pairs in Massachusetts enrolled in 1999-2002, the authors studied associations of maternal second-trimester fish intake and erythrocyte mercury levels with children's scores on the Peabody Picture Vocabulary Test (PPVT) and Wide Range Assessment of Visual Motor Abilities (WRAVMA) at age 3 years. Mean maternal total fish intake was 1.5 (standard deviation, 1.4) servings/week, and 40 (12%) mothers consumed >2 servings/week. Mean maternal mercury level was 3.8 (standard deviation, 3.8) ng/g. After adjustment using multivariable linear regression, higher fish intake was associated with better child cognitive test performance, and higher mercury levels with poorer test scores. Associations strengthened with inclusion of both fish and mercury: effect estimates for fish intake of >2 servings/week versus never were 2.2 (95% confidence interval (CI): -2.6, 7.0) for the PPVT and 6.4 (95% CI: 2.0, 10.8) for the WRAVMA; for mercury in the top decile, they were -4.5 (95% CI: -8.5, -0.4) for the PPVT and -4.6 (95% CI: -8.3, -0.9) for the WRAVMA. Fish consumption of < or =2 servings/week was not associated with a benefit. Dietary recommendations for pregnant women should incorporate the nutritional benefits as well as the risks of fish intake.
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                Author and article information

                Journal
                Environ Health Perspect
                Environmental Health Perspectives
                National Institute of Environmental Health Sciences
                0091-6765
                1552-9924
                August 2010
                8 June 2010
                : 118
                : 8
                : 1137-1145
                Affiliations
                [1 ] Department of Environmental Medicine, University of Southern Denmark, Odense, Denmark
                [2 ] Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, USA
                [3 ] Department of Environmental Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan
                [4 ] Division of Environmental Health Sciences, Akita University, Akita, Japan
                [5 ] National Institute for Minamata Disease, Minamata, Japan
                Author notes
                Address correspondence to P. Grandjean, Department of Environmental Health, Harvard School of Public Health, Landmark Center, 3E-110, Boston, MA 02115 USA. Telephone: (617) 384-8907. Fax: (617) 384-8994. E-mail: pgrand@ 123456hsph.harvard.edu

                P.G. has provided paid expert testimony on mercury toxicology for the U.S. Department of Justice in a legal case concerning environmental pollution from coal-fired power plants. The remaining authors declare they have no actual or potential competing financial interests.

                Article
                ehp-0901757
                10.1289/ehp.0901757
                2920086
                20529764
                d7237f7a-25be-454d-a7bb-107e4ec9a182
                This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original DOI.
                History
                : 1 December 2009
                : 8 June 2010
                Categories
                Review

                Public health
                toxicology,epidemiology,prevention and control,methylmercury compounds,seafood,empirical research,environmental exposure,public policy

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