Methylmercury and the health of indigenous peoples: a risk management challenge for physical and social sciences and for public health policy
Introduction
Methylmercury bio-accumulated in aquatic biota, especially fish, is a public health concern internationally. Current international efforts aimed at reducing the anthropogenic release of mercury into the environment by lowering emissions from combustion and non-combustion sources, and consequently, lessening the accumulation of methylmercury in aquatic ecosystems (Iverfeldt et al., 1995, Environmental Protection Agency, 1997), are an essential component of mercury risk management and policy development. To not apply this precautionary approach would result in increased amounts of bio-available mercury in the environment. However, given the persistence of the methylmercury already present in aquatic ecosystems, this approach must be viewed as a long-term consideration in terms of reducing human exposure to methylmercury. In the meantime, risk management and public health policies must address the existing problems of exposure to methylmercury, especially among sub-population groups such as indigenous peoples. Of particular concern are the impacts on indigenous populations which depend on fish, or sea mammals, as a subsistence food source, in both remote areas of developed countries, such as Canada (Wheatley, 1979), and in developing countries such as Brazil (Cleary, 1990). Research into these impacts over the past three decades, in Canada and a number of other countries, has shown that, other than in very severe pollution situations such as occurred in Minamata, Japan (Katsuna, 1968), the direct impacts on human health are difficult to prove (Wheatley et al., 1979, Wheatley and Paradis, 1996). On the other hand, the indirect, negative effects of methylmercury on health, mediated through the disruption of lifestyle and eating patterns and the subsequent socio-cultural and socio-economic consequences among the affected indigenous populations, have, in many cases, been significant (Erikson, 1994, Wheatley, 1996, Wheatley, 1997). These factors pose serious challenges in determining practical public health policy on the issue. This paper attempts to illustrate these difficulties and suggest possible approaches to risk management and policy development using the Canadian experience as a case study.
Section snippets
Defining the challenge
Most of the Canadian population of 30 million is concentrated in a band approximately 100 miles wide, north of the USA border. Indigenous peoples number approximately 400 000. The majority live in remoter areas, north of the main population belt. First Nations live south of the tree line and Inuit north of that line. Many of these people still, at least in part, follow traditional lifestyles, eating freshwater fish (Berkes, 1990), and in the north, seals and whales (Wheatley and Wheatley, 1988).
Discussion
Despite the concerns in Canada regarding the levels of methylmercury being found in some indigenous people, as mentioned earlier, it was not possible to prove direct, clinical effects, even though mild unprovable effects may have been present. Therefore, in terms of effects on adults, since fish and wildlife are such a vital component of their diet, culture, lifestyle and socio-economic well being, a risk management decision to advise them not to eat fish or wildlife because of methylmercury
Conclusion
The public health risk-management decisions, definition of public health policy and the provision of responsible public health advice may require a very difficult cross-discipline risk–benefit balance. On the medical side of the equation, the emphasis must be on the irreversibility of adverse neurological effects. Mild, transient effects are of some public health concern but they do not give sufficient reason to provide advice which will affect the diet, lifestyle, and ultimately, the health of
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