Philibert Aline, Fillion Myriam, Da Silva Judy, Lena Tanya Suvendrini, Mergler Donna
Université du Québec à Montréal, Centre de recherche interdisciplinaire sur le bien-être, la santé, la société et l'environnement (Cinbiose), CP 8888, Succ. Centreville, Montréal, Québec, H3C 3P8, Canada.
Département Science et Technologie, Université TÉLUQ, 5800 Saint Denis St, Montréal, Québec, H2S 3L4, Canada.
Environ Health. 2022 Mar 16;21(1):34. doi: 10.1186/s12940-022-00838-y.
The watershed in Asubpeeschoseewagong Netum Anishinabek (Grassy Narrows First Nation) territory has been contaminated by mercury (Hg) since 1962, resulting in very high Hg concentrations in fish, central to the community's culture, traditions, economy and diet. Biomarkers of Hg exposure (umbilical cord blood and hair/blood samples), monitored between 1970 and 1997, decreased over time. A recent Grassy Narrows Community Health Assessment (GN-CHA) survey included current symptoms of nervous system dysfunction. The present study aimed to cluster self-reported symptoms and examine their associations with past Hg exposure.
The GN-CHA included 391 adults. Symptom clustering used a two-step segmentation approach. Umbilical cord Hg and/or yearly measurements of equivalent hair Hg were available for 242 participants. Structural Equation Models (SEM) displayed the associations between Hg exposure and clusters, with Hg exposure modelled as a latent variable or in separate variables (prenatal, childhood and having had hair Hg ≥ 5 μg/g at least once over the sampling period). Longitudinal Mixed Effects Models (LMEM) served to examine past hair Hg with respect to clusters.
A total of 37 symptoms bonded into 6 clusters, representing Extrapyramidal impairment, Sensory impairment, Cranial nerve disturbances, Gross motor impairment, Neuro-cognitive deficits and Affect/Mood disorders. Median Hg concentrations were 5 μg/L (1-78.5) and 1.1 μg/g (0.2-16) for umbilical cord and childhood hair, respectively. More than one-third (36.6%) had hair Hg ≥ 5 μg/g at least once. In SEM, latent Hg was directly associated with Extrapyramidal and Sensory impairment, Cranial nerve disturbances and Affect/Mood disorders. Direct associations were observed for prenatal exposure with Affect/Mood disorders, for childhood exposure with Extrapyramidal impairment and Cranial nerve disturbances, and for hair Hg ≥ 5 μg/g with Extrapyramidal and Sensory impairment. For all clusters, a further association between past Hg exposure and symptom clusters was mediated by diagnosed nervous system disorders. LMEM showed higher past hair Hg among those with higher scores for all clusters, except Affect/Mood disorders.
Our findings provide evidence that in this First Nation community, past Hg exposure from fish consumption was associated with later-life clusters of coexisting symptoms of nervous system dysfunction.
自1962年以来，阿苏布皮肖塞瓦贡内图姆阿尼什纳贝克（青草浅滩第一民族）领地的分水岭受到汞污染，导致该社区文化、传统、经济和饮食中至关重要的鱼类汞含量极高。1970年至1997年期间监测的汞暴露生物标志物（脐带血和头发/血液样本）随时间下降。最近的青草浅滩社区健康评估（GN - CHA）调查纳入了当前神经系统功能障碍症状。本研究旨在对自我报告的症状进行聚类，并检查它们与过去汞暴露的关联。
GN - CHA包括391名成年人。症状聚类采用两步分割法。242名参与者有脐带汞和/或等效头发汞的年度测量数据。结构方程模型（SEM）展示了汞暴露与聚类之间的关联，汞暴露被建模为一个潜在变量或在单独变量中（产前、儿童期以及在采样期间头发汞至少有一次≥5μg/g）。纵向混合效应模型（LMEM）用于检查过去头发汞与聚类的关系。
总共37种症状聚为6个聚类，分别代表锥体外系损伤、感觉损伤、颅神经紊乱、粗大运动损伤、神经认知缺陷和情感/情绪障碍。脐带血和儿童期头发汞的中位数浓度分别为5μg/L（1 - 78.5）和1.1μg/g（0.2 - 16）。超过三分之一（36.6%）的人头发汞至少有一次≥5μg/g。在SEM中，潜在汞与锥体外系和感觉损伤、颅神经紊乱以及情感/情绪障碍直接相关。观察到产前暴露与情感/情绪障碍、儿童期暴露与锥体外系损伤和颅神经紊乱、头发汞≥5μg/g与锥体外系和感觉损伤之间存在直接关联。对于所有聚类，过去汞暴露与症状聚类之间的进一步关联由诊断出的神经系统疾病介导。LMEM显示，除情感/情绪障碍聚类外，所有聚类得分较高者过去头发汞含量更高。
我们的研究结果提供了证据，表明在这个第一民族社区，过去因食用鱼类导致的汞暴露与晚年共存的神经系统功能障碍症状聚类有关。
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