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Between 2000-2013, an analysis of Florida Poison Control Centers regarding calls that were made about informational queries and exposure-report calls about mercury. The data used to analyze the calls to the Florida Poison Control Centers were entered in ToxSentry which is a standardized data base. Once the data was de-identified the calls were put into two categories; exposure or informational. There were 3,573 mercury related calls between 2000-2013, 82% of those calls were exposure-related calls while 18% of the calls were for informational purposes. To compare, in 2003 469 calls about mercury were recorded however in 2013 only 136 calls were mercury related. (see table below) (Gribble, M. O., Hunter, C. M., Deshpande, A., Stephan, W. B., & Weisman, R. S.) The analysis concluded that while calls regarding mercury exposure was found to have decreased, the number of informational queries have increased. The Food Safety Surveys produced national data that shows an increase in awareness of mercury in seafood in the parents of small children in contrast recent surveys of a region near Pensecola, Florida shows only 31% of women are aware of mercury in seafood.

In 2010, an informational campaign called “Don’t mess with Mercury” regarding mercury exposure was released that may have contributed to the changes over time in the mercury related calls to the Florida Poison Control Centers. The limitations that were found with this analysis included, limited ability to assess if the informational campaign had any influence on the number of informational calls that were received, there may have also been a misclasification of the mercury exposure related calls (Gribble, M. O., Hunter, C. M., Deshpande, A., Stephan, W. B., & Weisman, R. S.) Another limitation found with this analysis is the fact that there are other numbers that the residents of Florida could have called to report mercury exposure and seek information regarding mercury.

The National Health and Nutrition Examination Survey’s (NHANES) data was used from 1999-2010 to determine trends in women 16-49 who lived in different regions in the United States(Cusack, L. K., Smit, E., Kile, M. L., & Harding, A. K. 2017). This data looked at blood mercury and it also looked specifically at age, race/ethnicity, socioeconomic status and the consumption of fish and it also took into account variables depending on geographic location. An interview was done that asked the women about their consumption of fish or shellfish in the last 30 days. They were specifically asked about 31 types of fish consumed in the last 30 days. The data that was used for calculations included frequency of consumption and type of fish consumed. The type of fish consumed was broken down into categories; tuna, predatory fish, marine fish, freshwater fish and marine shellfish. The total blood mercury as well as blood inorganic mercury was also measured in this analysis. The analysis found that women in the Northeast had the highest percentage of blood mercury concentrations while women in the midwest had the lowest percentage of blood mercury concentrations.

Fig. 1 A map of whole blood mercury concentration (geometric mean and 95% Confidence Interval (μg/L)) in women of childbearing ages by coastal/inland regions for NHANES 1999–2010

Shellfish was found to be the most consumed fish in all regions except Inland West and Inland Midwest. Women living in the Gulf of Mexico was found to consume freshwater fish the most, marine fish was found to be consumed most often by women living in the Pacific Coast region. The consumption of tuna was most often consumed in the Great Lakes Region and shellfish was found to be most often consumed in the Gulf of Mexico region. According to the data the consumption of fish increased as age and household income increase. Mexican Americans were found to consume the least amount of fish monthly while participants that identified as either Other, Asian American, Pacific Islander, Alaska natives and Native Americans were found to consume the most total fish on a monthly basis. Non-Hispanic Blacks were found to consume the most fresh water fish in the past 30 days (Cusack, L. K., Smit, E., Kile, M. L., & Harding, A. K. 2017).

The NHANES analysis concluded that although fish consumption is increasing, whole blood levels are decreasing however a substantial number of U.S. women have blood mercury levels above the EPA’s reference level. It was also concluded that the women are not eating the amount of fish recommended by the American dietary guidelines, which is twice a week.

Fig. 2 Distribution of Total Blood Mercury (ug/L), by NHANES survey cycle, for women of childbearing age

Fig. 4 Distribution of total fish consumption (meals per month), by NHANES survey cycle, for women of childbearing age

The ecological perspective may have been used to predict the trends that were identified. This theory looks at multiple factors that influence the way people interact with both their physical and socio-cultural environments. When looking at mercury related exposure you have to consider the many factors that are involved including; form of mercury exposure, age of person exposed, how the exposure occurred, length of exposure, co-morbidities of the person exposed and the amount of exposure. When you consider these factors, it will allow you to gain a better understanding about mercury related exposure and how it occurs. Being able to monitor or predict the environmental health trends when it relates to mercury is very important. Healthcare professionals and researchers need to work more closely together to help fill the gaps in knowledge as it relates to mercury exposure. Increasing awareness through national or local campaigns in regards to mercury related exposure allows one to make informed decisions and would be considered a proactive solution to the problem that will help to develop future interventions.

Reference

Bjørklund, G., Dadar, M., Mutter, J., Aarseth, J., The toxicology of mercury: Current research and emerging trends, Environmental Research, Volume 159, 2017, Pages 545-554, ISSN 0013-9351

Cusack, L. K., Smit, E., Kile, M. L., & Harding, A. K. (2017). Regional and temporal trends in blood mercury concentrations and fish consumption in women of child bearing Age in the United States using NHANES data from 1999-2010. Environmental Health: A Global Access Science Source, 161-11. doi:10.1186/s12940-017-0218-4

Gribble, M. O., Hunter, C. M., Deshpande, A., Stephan, W. B., & Weisman, R. S. (n.d). Calls to Florida Poison Control Centers about mercury: Trends over 2003-2013. Environmental Research, 159422-426.