Assessing Children's Exposures and Risks to Drinking Water Contaminants: A Manganese Case Study

Background: Compared to adults, children maybe more highly exposed to toxic substances in drinking water because they consume more water per unit of body weight. The U.S. Environmental Protection Agency (USEPA) has developed new guidance for selecting age groups and age-specific exposure factors for assessing children's exposures and risks to environmental contaminants. Research Aim: To demonstrate the application and importance of applying age-specific drinking water intake rates, health reference values, and exposure scenarios when assessing drinking water exposures because these approaches illustrate the potential for greater potential for adverse health effects among children. Methods: manganese, an essential nutrient and neurotoxicant, was selected as a case study and chemical of potential concern for children's health. A screening-level risk assessment was performed using age-specific drinking water intake rates and manganese concentrations from U.S. public drinking water systems. Results: When age-specific drinking water intake rates are used to calculate dose, formula-fed infants receive the highest dose of manganese from drinking water compared to all other age groups. Estimated hazard quotients suggest adverse health effects are possible. Use of USEPA's standardized childhood age groups and childhood exposure factors significantly improves the understanding of childhood exposure and risks.     

The effect of high dose oral manganese exposure on copper,iron and zinc levels in rats

Manganese is an essential dietary nutrient and trace element with important roles in mammalian development, metabolism, and antioxidant defense. In healthy individuals, gastrointestinal absorption and hepatobiliary excretion are tightly regulated to maintain systemic manganese concentrations at physiologic levels. Interactions of manganese with other essential metals following high dose ingestion are incompletely understood. We previously reported that gavage manganese exposure in rats resulted in higher tissue manganese concentrations when compared with equivalent dietary or drinking water manganese exposures. In this study, we performed follow-up evaluations to determine whether oral manganese exposure perturbs iron, copper, or zinc tissue concentrations. Rats were exposed to a control diet with 10 ppm manganese or dietary, drinking water, or gavage exposure to approximately 11.1?mg manganese/kg body weight/day for 7 or 61 exposure days. While manganese exposure affected levels of all metals, particularly in the frontal cortex and liver, copper levels were most prominently affected. This result suggests an under-appreciated effect of manganese exposure on copper homeostasis which may contribute to our understanding of the pathophysiology of manganese toxicity.     

Impact assessment of ionizing radiation on human and non-human biota from the vicinity of a near-surface radioactive waste repository

This work describes the radiological assessment of the near-surface Maisiagala radioactive waste repository (Lithuania) over the period 2005–2012, with focus on water pathways and special emphasis on tritium. The study includes an assessment of the effect of post-closure upgrading, the durability of which is greater than 30 years. Both human and terrestrial non-human biota are considered, with local low-intensity forestry and small farms being the area of concern. The radiological exposure was evaluated using the RESRAD-OFFSITE, RESRAD-BIOTA and ERICA codes in combination with long-term data from a dedicated environmental monitoring programme. All measurements were performed at the Lithuanian Institute of Physics as part of this project. It is determined that, after repository upgrading, radiological exposure to humans are significantly lower than the human dose constraint of 0.2 mSv/year valid in the Republic of Lithuania. Likewise, for non-human biota, dose rates are below the ERICA/PROTECT screening levels. The potential annual effective inhalation dose that could be incurred by the highest-exposed human individual (which is due to tritiated water vapour airborne release over the most exposed area) does not exceed 0.1 μSv. Tritium-labelled drinking water appears to be the main pathway for human impact, representing about 83 % of the exposure. Annual committed effective dose (CED) values for members of the public consuming birch sap as medical practice are calculated to be several orders of magnitude below the CEDs for the same location associated with drinking of well water. The data presented here indicate that upper soil-layer samples may not provide a good indication of potential exposure to terrestrial deep-rooted trees, as demonstrated by an investigation of stratified ³H in soil moisture, expressed on a wet soil mass basis, in an area with subsurface contamination.     

Experimental Comparison of the Reproductive Outcomes and Early Development of the Offspring of Rats Given Five Common Types of Drinking Water

Tap water (unfiltered), filtered tap water and processed bottled water (purified water, artificial mineralized water, or natural water) are now the five most widely consumed types of drinking water in China. However, the constituents (organic chemicals and inorganic ingredients) of the five waters differ, which may cause them to have different long-term health effects on those who drink them, especially sensitive children. In order to determine which type of water among the five waters is the most beneficial regarding reproductive outcomes and the developmental behaviors of offspring, two generations of Sprague–Dawley rats were given these five waters separately, and their reproductive outcomes and the developmental behaviors of their offspring were observed and compared. The results showed that the unfiltered tap water group had the lowest values for the maternal gestation index (MGI) and offspring''s learning and memory abilities (OLMA); the lowest offspring survival rate was found in the purified water group; and the highest OLMA were found in the filtered tap water group. Thus, the best reproductive and offspring early developmental outcomes were found in the group that drank filtered tap water, which had the lowest levels of pollutants and the richest minerals. Therefore, thoroughly removing toxic contaminants and retaining the beneficial minerals in drinking water may be important for both pregnant women and children, and the best way to treat water may be with granular activated carbon and ion exchange by copper zinc alloy.     

Systematic review of exposure to albendazole or mebendazole during pregnancy and effects on maternal and child outcomes,with particular reference to exposure in the first trimester

Soil-transmitted helminth infections cause an important burden of morbidity worldwide, primarily from blood loss and malabsorption of nutrients. Where STH endemicity ≥20%, the World Health Organization (WHO) recommends preventive chemotherapy with single dose anthelminthic drugs: albendazole or mebendazole. Although WHO recommends that women of reproductive age, including pregnant women after the first trimester, be included in large-scale deworming programs, there are concerns related to the use of anthelminthic drugs during pregnancy, especially inadvertent use in the first few weeks when the pregnancy may not yet be confirmed. We therefore conducted a systematic review using the MEDLINE database with the aim of appraising all peer-reviewed evidence, published up to July 1, 2018, on the association between exposure to albendazole or mebendazole and outcomes in pregnant women, including those in the first trimester of pregnancy, and their children. From a yield of 205 papers based on titles alone, 58 papers, reporting results from 46 originator studies conducted in pregnant populations, constituted the initial evidence base. Among the nine originator observational studies which had included women in the first trimester of pregnancy within their study population, five compared birth outcomes between women exposed in the first trimester with women who were not exposed, and none reported higher rates of adverse birth outcomes in the exposed group. Due to heterogeneity in terms of study design, sample size, deworming drug, dosage and outcomes measured, data from these studies could not be pooled. Based on this cumulative evidence, it is unlikely that inadvertent exposure to albendazole or mebendazole in the first trimester carries an additional risk of adverse birth outcomes. To optimize relevance for policy making, future research in pregnant populations should aim to provide data disaggregated by trimester and to report on maternal and child adverse events, whenever possible.     

Determination of Arsenic Scalp Hair of Pakistani Children and Drinking Water for Environmental Risk Assessment

This cross-sectional study measured the arsenic level in scalp hair samples of children from two age groups exposed to contaminated underground water in Pakistan. The As concentrations in water and scalp hair samples were analyzed by electrothermal atomic absorption spectrometry. The studied areas were divided into three regions based on concentration of As in water and scalp hair of children who had been exposed to different levels of As through drinking water. The average As concentrations in underground water samples of sub-districts Faiz Ganj, Thari Mirwah, and Gambat were observed to be 15.2, 28.5, and 98.3 μg/L, respectively, which were marked as less, medium, and highly contaminated areas, respectively. The proportion of the children with lower body mass index significantly increased with increasing As exposure level; the dose–response relationship was consistently observed among the subgroups. The range of As concentrations in scalp hair samples of children of age 1–5 and 6–10 years was 0.21–3.88 and 0.32–3.63 μg/g, respectively. Thus, it is likely that children in our study areas are chronically exposed to As through drinking groundwater, suggesting that there is an urgent need to take immediate solution, especially in the Gambat sub-district.     

Platinum cytotoxic drugs in the municipal wastewater and drinking water,a validation method and health risk assessment

Three cancerostatic platinum compounds (CPCs) including cisplatin, carboplatin and oxaliplatin are complexes of Pt and classified as probable carcinogenic compounds to humans. This study aimed to perform health risk assessment of platinum cytotoxic drugs for drinking water by developing a sensitive analytical method in the water resource of Qom Province in the central part of Iran. Concentrations of the platinum drugs were determined, including 052 ± 0.2 µg/L for cisplatin, 0.94 ± 0.36 µg/L for carboplatin and 0.27 ± 0.16 µg/L for oxaliplatin in influent samples, and 0.24 ± 0.07 µg/L for cisplatin, 0.28 ± 0.05 µg/L for carboplatin and 0.11 ± 0.01 µg/L for oxaliplatin in effluent samples. The results indicated that in all the well water samples related to the groundwater, the concentration of the platinum-based compounds was lower than the calculated limits of quantification (LOQ); the concentration of cisplatin, carboplatin and oxaliplatin across the samples in the station of drinking water distribution was also below the limits of detection (LOD). The resulting margin of exposure (MOE) is lower than one (MOE < 1) for the three groups including children, pregnant women and lactation women related to cisplatin and carboplatin was determined through exposure to raw and untreated drinking water. Further research is recommended to be conducted in this area, particularly environmental fate of metabolites and transformation products.     

Indication of silicon essentiality in humans

Serum silicon concentrations were determined in Belgian healthy children and adults, including pregnant women, by electrothermal atomic absorption spectrometry. Serum levels appeared to be significantly higher in healthy children (1–18 yr) than in healthy adults (19–60 yr). Especially, levels in infants (<1 yr) were higher than in any other group. Compared to age-matched nonpregnants, the serum silicon content was very low in pregnant women. In addition to the fact that this study for the first time provides serum silicon values in adults and children in Belgium, the most important observation is that these serum profiles might be an indication of silicon essentiality in man.     

Nongenital malformations following exposure to progestational drugs: the last chapter of an erroneous allegation

In the late 1960s and 1970s, a number of epidemiological studies were published indicating that pregnant women who were exposed to an array of sex steroids delivered infants with an increased incidence of nongenital congenital malformations. Because of these publications, the Food and Drug Administration (FDA), in conjunction with various pharmaceutical companies, labeled the therapeutic exposure of progestational drugs and contraceptives in pregnant women as a risk factor for limb‐reduction defects (LRDs) and congenital heart defects (CHDs). Subsequently there was a rapid decrease in the exposure of pregnant women to these drugs and the initiation of numerous lawsuits alleging that a particular progestational drug was responsible for a child's nongenital congenital malformation. Wilson and Brent ( 1981 ) published an article indicating that epidemiological and animal studies of these drugs, and basic science did not support the package insert's warnings. Many new and previous animal and epidemiological studies did not support the FDA box warning. In 1987 the FDA held a hearing in which the FDA, the Teratology Society, the Centers for Disease Control and Prevention, the American College of Obstetrics and Gynecology, and other organizations supported the position that progestational agents did not result in nongenital malformations. An editorial appeared in Teratology congratulating the FDA for removing the warning label on oral contraceptives regarding nongenital malformations. In 1999 the FDA published new wording for package inserts that removed warnings for nongenital malformations for all progestational agents. In spite of the recent changes in the package inserts, lawsuits have alleged that progestational drugs cause nongenital malformations. It took 22 years from the time a box warning was required by the FDA until the warnings were removed in 1999. The 1999 FDA publication, which is a scholarly and objective document, should put an end to 2 decades of concern and anxiety for pregnant women or women of reproductive age. Could scientists, the pharmaceutical companies, or the FDA have prevented the mislabeling of progestational drugs with regard to their teratogenic risks? Was the epidemiological or teratology community at fault because they did not critique and respond to the early publications? Did the FDA act too slowly? The epidemiologic analyses, animal studies, and basic science principles have been reviewed, and it is obvious that clinically utilized progestational drugs do not cause nongenital malformations (i.e., LRDs and CHDs). Birth Defects Research (Part A) 2005. © 2005 Wiley‐Liss, Inc.     

Non-Carcinogenic Risk Assessment of Heavy Metals and Fluoride in Some Water Wells in the Al-Baha Region,Saudi Arabia

On a global scale, pathogenic contamination of drinking water poses the most significant health risk to humans. However, significant risks to human health may also result from exposure to nonpathogenic, toxic contaminants that are often ubiquitous in waters. The purpose of this study is to determine the levels of heavy metal and fluoride contaminants in water wells used in the Al-Baha region, Saudi Arabia, to evaluate if the levels of metals will have non-carcinogenic effects. Samples were collected from private wells in the area and were analyzed for chemical contamination using approved methods of collection and analysis. Chromium, manganese, zinc, iron, and fluoride were detected in all samples, and were selected for toxicological evaluation. Exposure through ingestion and dermal contact were the scenarios proposed in this study. Chronic daily intakes (CDIs) were estimated for both routes and then compared with health guideline values. The non-cancer risk estimations show that manganese, chromium, and zinc individually have oral Hazard Quotient (HQ) values less than a value of one. Iron and fluoride were found to have oral HQ values greater than 1 in some samples. Also, on considering the additive effect of the contaminants we found that some samples have Hazard Index (HI) values greater than 1, which indicates that there is a concern for chronic non-cancer adverse health effects in case of oral and dermal routes of exposure to water from these wells.     

Radiation exposure from radionuclides in ground water: an uncertainty analysis for selected exposure scenarios

The uncertainty of the potential radiation exposure of the general population has been estimated for a normalized contamination of ground water that is being used as drinking water for humans and animals, for irrigation of food and feed crops, and for fish production in freshwater bodies. The frequency distributions of annual effective dose equivalents were calculated assuming a normalized activity concentration in water of 1 Bq/l for each radionuclide considered. Estimated frequency distributions of the parameters were used as model input. This estimation is based on an exposure scenario which reflects the present radioecological conditions. Another important source for the uncertainty of the potential dose due to radionuclides released to the ground water is the uncertainty of the exposure scenario. Since such a contamination may not occur before some time in the far future, it is impossible to predict the exact boundary conditions. Therefore, scenarios were simulated with modified consumption habits, more extensive farm management and different climatic conditions. The distributions of the potential doses cover in general about a factor of 10–20. The intake of drinking water, the root uptake and the contamination of fish are most important for the resulting potential radiation exposure. For nearly all radionuclides, the intake of drinking water dominates the potential exposure. In most cases radioactive daughter nuclides are of minor importance. In general, the influence of the exposure scenario on the dose is relatively small. Received: 21 December 1995 / Accepted in revised form: 3 June 1996     

Sediment analysis for the assessment of risk from organic pollutants in lakes

Sediment analysis in three Italian subalpine lakes, very close to each other and exposed to different anthropogenic pressure, was used to assess the risk from organic pollutants, including some very persistent and widespread micropollutants (PCB, DDT, PAH) as well as known local pollutants. Additionally, a wide-spectrum characterization of organic compounds by GLC-MS analysis allowed the detection of other classes of chemicals. The contamination levels were related to long distance transport and to local sources of pollution in the watershed. PAH, PCB and organochlorine pesticide levels agree with the load calculated from atmospheric depositions. Local sources of pollution are responsible for the contamination by aliphatic hydrocarbons and tris(monochloroisopropyl)-phosphate (TCIPP); these compounds were found only in the two most urbanized basins. Heavy contamination by TCIPP was found in both water and sediments; water concentrations are considered hazardous for drinking purposes. This study shows that local contaminants, not yet included in any priority list, may single; out as a major environmental concern.     

Impact of Prenatal and Postnatal Treatment of Sodium Fluoride and Aluminum Chloride on Some Hormonal and Sensorimotor Aspects in Rats

In most communities, there is a constant exposure to environmental pollutants with probable negative impact on the development of the nervous system. Among these pollutants are the sodium fluoride (NaF) and aluminum chloride (AlCl₃) which may represent a real threat to the proper functioning of the brain. This study comprises two fundamentally different strategies; in the first one, pregnant rats were administered a daily dose of NaF (0.15 g /L) or AlCl₃ (500 mg/L) in the drinking water either separately or in combination with each other from day 6 of gestation until just after weaning. In the second approach, the male rats born to mothers exposed to the pollutants were divided into two groups. In the first, rats were continued to be treated with the same pollutants administered to them in the drinking water at the same dose level until the age of 70 days. The rats of the second group were supplied with drinking water without either one of the pollutants for a similar period of time. The rats exposed to NaF separately or in combination with AlCl₃ during the prenatal life and subsequently through the postnatal stages exhibited disturbance in the locomotor activities. This was concomitant with alterations in plasma, PTH, ACTH, and estradiol levels. Additionally, the serum levels of LH and testosterone were altered in the two groups treated with sodium fluoride during the prenatal and up to the weaning periods or in the group which continued to have the NaF until day 70 after birth.     

Children's exposure to environmental pollutants and biomarkers of genetic damage. II. Results of a comprehensive literature search and meta-analysis

The present review is based on findings from 178 publications retrieved through an extensive search of the MedLine/PubMed database for a 25 years time period (1980-2004) and 10 manually identified papers. Among the cytogenetic biomarkers that are frequently used in field studies, chromosome aberrations (CA) and micronuclei (MN) but not sister chromatid exchanges (SCE) were found consistently increased in children exposed to environmental pollutants. Meta-analysis of the studies reporting SCE in cord blood showed similar levels of SCE in exposed and in non-exposed newborns. Exposure to airborne pollutants, soil and drinking water contaminants, mostly increased CA and, to a lesser extent, MN levels in children. The effect of exposure to airborne urban pollutants was consistently reported by field studies measuring DNA, albumin and hemoglobin adducts. Prenatal (in utero) and postnatal exposure (environmental tobacco smoke, ETS) to tobacco smoke compounds were associated with increased frequencies of DNA and hemoglobin adducts and CA. The limited number of field studies measuring DNA fragmentation (Comet assay), hypoxanthine-guanine phosphoribosyltransferase (HPRT) and the glycophorinA (GPA) mutation frequency in environmentally exposed children precluded a meaningful evaluation of the usefulness of these assays. Meta-analyses performed in children exposed to ETS and in newborns exposed in utero to their mothers' smoke showed 1.3 and 7 times higher levels of hemoglobin adducts compared to referent subjects, respectively. These increases are consistent with the epidemiological evidence of higher lung cancer risks reported in adults who had never smoked and were exposed to ETS during childhood and with 7-15 times higher lung cancer risks reported in smokers than in non-smokers. Higher levels of PAH-DNA adducts were found in fetal than in maternal tissue, suggesting a specific susceptibility of the fetus to this class of ubiquitous environmental pollutants. According to these findings, future research and biomonitoring programs on children would greatly benefit from the inclusion of selected biomarkers that could provide biologically based evidence for the identification of intervention priorities in environmental health.     

Prevention of unnecessary pregnancy terminations by counselling women on drug, chemical, and radiation exposure during the first trimester

As part of a new approach to counselling pregnant women concerned about antenatal exposure to drugs, chemicals, or radiation, we measured their tendency to terminate their pregnancy by using a visual analogue scale (VAS). Analysis of 78 cases where women had less than 50% tendency to continue pregnancy before they were advised by us reveals that 61 decided to continue their pregnancy after the consultation (57 normal, healthy infants, four miscarriages) and 17 terminated. Women who continued their pregnancy significantly changed their tendency after we discussed relevant information with them (from 34.3 +/- 2.5% to 84.5 +/- 3.3%, P less than 0.00001), whereas most of those who eventually terminated pregnancy did not change their tendency to continue pregnancy beyond the 50% mark (from 24.8 +/- 5.4% to 45.1 +/- 9.8%) (P greater than 0.1). Only two of the women who terminated their pregnancy were exposed to teratogenic drugs; however, in most other cases, other obvious reasons, unrelated to the exposure in question, were identified by the women as leading reasons for termination. An appropriate intervention in early pregnancy can prevent unnecessary pregnancy terminations by correcting misinformation and thereby decreasing the unrealistically high perception of risk by women exposed to nonteratogens.     

Pre and Post Natal Exposure of Fluoride Induced Oxidative Macromolecular Alterations in Developing Central Nervous System of Rat and Amelioration by Antioxidants

The effect of fluoride exposure during gestation and post gestation periods were studied to check the status of oxidant, antioxidant and macromolecular changes in CNS and ameliorative role of antioxidants. The pregnant Wistar albino rats were exposed to 50 and 150 ppm fluoride in drinking water and the pups born to them were used for experimentation. After postpartum, the pups were administered daily selected antioxidants through oral gavage. On 21st postnatal day pups were sacrificed and biochemical parameters were assessed. Fluoride exposure substantially increased the activity/levels of fluoride, LPO, protein oxidation, MAO-B, GOT, GPT and decreased protein thiols, RNA and total proteins in discrete regions of CNS. The findings evidenced fluoride induced dyshomeostasis caused on antioxidants, enzymes, macromolecules and governed the pathophysiological events leading to functional loss in a dose dependent manner. The administration of antioxidants remedied the disquiet caused by high fluoride exposure at extreme vulnerable periods of life.     

Variations in concentration of fluoride in blood plasma of pregnant women and their possible consequences for amelogenesis in a fetus

The aim of the study was to assess the fluoride exposure of pregnant women living in Poznan (Poland) by examination of fluoride levels in blood plasma.

The subjects of the study were 31 pregnant women aged 22–34 years in the course of regular pregnancy. Data concerning the sources of fluoride exposure such as diet, oral hygiene measures and topical application of fluoride procedures, were collected from each individual with a questionnaire. Samples of blood plasma were drawn in the 28th, 33rd week of pregnancy and during delivery. The analysis evaluating the fluoride concentration in the samples was carried out with the use of fluoride electrode ORION (model 96-09). The data were statistically analyzed using the program Statistica for Windows.

Mean value of fluoride concentration in the samples of blood plasma from the 28th week of pregnancy was lower than the mean concentration detected in the 33rd week of pregnancy (3.29 and 3.73 μmol/l, respectively). These values suggest that apart from drinking water, there were other important sources of fluoride in the examined sample.

The results indicate that a reliable assessment of fluoride exposure in a given population cannot be based solely on the concentration of fluoride in drinking water. Relatively high levels of fluoride in blood plasma of examined women suggest that there is no need for fluoride supplementation in this group of patients.     

Prenatal Exposure to Carbamazepine Reduces Hippocampal and Cortical Neuronal Cell Population in New-Born and Young Mice without Detectable Effects on Learning And Memory

Pregnant women with epilepsy have to balance maternal and fetal risks associated with uncontrolled seizures against the potential teratogenic effects from antiepileptic drugs (AEDs). Carbamazepine (CBZ) is among the four most commonly used AEDs for treatment of pregnant epileptic women. We previously reported that new-born children had a decreased head circumference after in utero CBZ exposure. This study investigates how prenatal exposure of CBZ influences the number of neurons in new-born and young mouse hippocampus, amygdala and cortex cerebri. Clinical studies describe inconclusive results on if prenatal CBZ treatment influences cognition. Here we investigate this issue in mice using two well characterized cognitive tasks, the passive avoidance test and the Morris water maze test. Prenatal exposure of CBZ reduced the number of neurons (NeuN-immunoreactive cells) in the new-born mouse hippocampus with 50% compared to non-exposed mice. A reduction of neurons (20%) in hippocampus was still observed when the animals were 5 weeks old. These mice also displayed a 25% reduction of neurons in cortex cerebri. Prenatal CBZ treatment did not significantly impair learning and memory measured in the passive avoidance test and in the Morris water maze. However, these mice displayed a higher degree of thigmotaxic behaviour than the control mice. The body weight of prenatally CBZ exposed five-week old mice were lower compared to control mice not exposed to CBZ (p = 0.001). In conclusion, prenatal exposure to CBZ reduces the number of neurons dramatically in areas important for cognition such as hippocampus and cortex, without severe impairments on learning and memory. These results are in line with some clinical studies, reporting that CBZ has minor negative effects on cognition. The challenge for future studies are to segment out what possible effects a reduction of neurons could have on different types of cognition, like intellectual ability and social interaction.     

Evaluation of a Public Health Intervention to Lower Mercury Exposure from Fish Consumption in Bermuda

Objectives

To assess the efficacy of a public health intervention to reduce blood mercury (Hg) concentration levels in pregnant Bermudian women.

Methods

In 2003, we conducted a study entitled “Prenatal exposure of the Bermudian Population to Environmental Contaminants” which provided Bermuda’s first baseline data on prenatal exposure to several environmental contaminants, including Hg. The mean Hg concentration from 42 healthy newborns measured in umbilical cord blood was 41.3 nmol/L, ranging from 5–160 nmol/L. This concentration was much higher than expected, being approximately 8 times the general levels found in Canada and the U.S. Furthermore, we estimated that 85% of total Hg measured was in the form of methylmercury (MeHg), indicating that seafood consumption was the primary source of Hg exposure during pregnancy in Bermuda. Locally sourced seafood was identified as the most significant possible contributory source of Hg exposure. In 2005 the authors began a complementary research programme to study the levels of Hg in local commercial fish species. Coming out of this research were specific local fish consumption guidelines issued by the Department of Health advising pregnant women to avoid those local fish species found to be high in Hg while still encouraging consumption of fish species having lower Hg levels.

Results

In 2010, under another research initiative, we returned to Bermuda to carry out another evaluation of Hg in human blood. Hg was measured in the blood of 49 pregnant women. The arithmetic mean Hg blood concentration was 6.6 nmol/L and the geometric mean 4.2 nmol/L. The maximum concentration found was 24 nmol/L.

Conclusions

Hg exposure of Bermudian pregnant women has dropped significantly by a factor of around 5 since the foetal cord blood study in 2003.     

Are There Health Risks from the Migration of Chemical Substances from Plastic Pipes into Drinking Water? A Review

Plastic pipes used to convey hot and cold drinking water are synthetic polymers containing numerous additives that enhance durability, impact strength, and toughness, and resist material degradation. Although some research studies have been conducted to evaluate the type and levels of chemical substances migrating from polymeric materials into drinking water, the potential adverse health effects associated with these compounds in potable water have not been described. This review evaluates the literature on the occurrence of regulated and unregulated substances in drinking water related to the use of plastic pipes, characterizes potential health hazards, and describes uncertainties associated with human health and exposure in need of further research. Of particular public health concern is the potential for sensitive populations to be exposed to short-term elevations in leachates during critical periods, and for co-occurring leachates targeting the same organ(s) and/or sharing a common mode of toxic action to have additive or synergistic effects. Contaminants are measured in the distribution system, not at the tap where human exposure actually occurs. For increased health protection, it is important to identify compounds that migrate from plastic pipes into drinking water and to better quantify human exposures and health hazards to these substances and their degradates.