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Roundtable Discussion Groups Summary Papers: New Bioindicators for Mercury

Toxicological Assessment: Recommendations from the First International
Bioindicators Roundtable
Article in Environmental Bioindicators · September 2007

DOI: 10.1080/15555270701626422
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Roundtable Discussion Groups Summary Papers: New
Bioindicators for Mercury Toxicological Assessment:
Recommendations from the First International
Bioindicators Roundtable
Diane Henshel a; Micheal Aschner b; Niladri Basu c; William Bowerman d; Diana
Echeverria e; Michael Gilbertson f; Nicholas Ralston g; Darren Rumbold h; Martine
Wolfe i
a
School of Public and Environmental Affairs, Indiana University, Bloomington, IN,
USA
b
Pediatrics and Pharmacology, Vanderbilt University, Nashville, TN, USA
c
Center for Advanced Research in Environmental Genomics, University of Ottawa,
Ottawa, ONT, Canada
d
Forestry and Natural Resources, Clemson University, Clemson, SC, USA
e
School of Public Health and Community Medicine, University of Washington Environmental and Occupational Health
Sciences, Seattle, WA, USA
f
Occupational and Environmental Health Research Group, University of Stirling, Scotland, UK
g
Energy and Environmental Research Center, University of North Dakota, Grand Forks, ND, USA
h
Department of Marine and Ecological Sciences, Florida Gulf Coast University, Fort Myers, FL, USA
i
Department of Biological Sciences, California State University, Chico, CA, USA
Online Publication Date: 01 July 2007

To cite this Article: Henshel, Diane, Aschner, Micheal, Basu, Niladri, Bowerman, William, Echeverria, Diana,
Gilbertson, Michael, Ralston, Nicholas, Rumbold, Darren and Wolfe, Martine (2007) 'Roundtable Discussion Groups
Summary Papers: New Bioindicators for Mercury Toxicological Assessment: Recommendations from the First
International Bioindicators Roundtable', Environmental Bioindicators, 2:3, 183 - 207
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Roundtable Discussion Groups Summary Papers

1555-5267
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Environmental Bioindicators,
Bioindicators Vol. 2, No. 3, Aug 2007: pp. 0–0
Editors’ Note:
At the 14th International Conference on Environmental Bioindicators
th
(14 ICEBI) held in Linthicum Heights, Maryland, USA on 24–26 April 2006,
the Conference Chairs and Program Committee initiated the Roundtable
Discussion Groups as a prominent and regular feature of this and future con-
ferences. The Discussions are designed to generate focused debate around key
topic areas, led by academic, government and industry experts, and are struc-
tured to produce definitive papers for peer review and publication in EBI’s
first-quarter issues of each publication year. The three Roundtables of the 14th
ICEBI posed questions revolving around the chosen topic areas of Mercury
Bioindicators, Marine Ecosystem-level Indicators, and Regulatory and Policy
Uses of Bioindicators, and moved from “what we know” to “where we need to
go” and “what are the policy implications from our discussions and conclu-
sions.” The paper on coral reef indicators was published in EBI 2(1) and was
the first product of this undertaking. The second Roundtable paper on Regula-
tory and Policy Uses of Bioindicators was published in EBI 2(2). The follow-
ing paper on Mercury Bioindicators is the final paper of this series.
New Bioindicators for Mercury Toxicological

Assessment: Recommendations from the First
International Bioindicators Roundtable
DIANE HENSHEL,1 MICHEAL ASCHNER,2 NILADRI BASU,3

New Bioindicators
Henshel et al. for Mercury
WILLIAM BOWERMAN,4 DIANA ECHEVERRIA,5

MICHAEL GILBERTSON,6 NICHOLAS RALSTON,7
DARREN RUMBOLD,8 AND MARTINE WOLFE9
1
School of Public and Environmental Affairs, Indiana University, Bloomington, IN,
USA
2
Pediatrics and Pharmacology, Vanderbilt University, Nashville, TN, USA
3
Center for Advanced Research in Environmental Genomics, University of
Ottawa, Ottawa, ONT, Canada
4
Forestry and Natural Resources, Clemson University, Clemson, SC, USA
5
School of Public Health and Community Medicine, University of Washington
Environmental and Occupational Health Sciences, Seattle, WA, USA
6
Occupational and Environmental Health Research Group, University of Stirling,
Scotland, UK
Address correspondence to Diane Henshel, Indiana University, School of Public and Environ-
mental Affairs, 1315 E 10th Str #340, Bloomington, IN 47401, USA. E-mail: dhenshel@gmail.com
183
184 Henshel et al.
7
Energy and Environmental Research Center, University of North Dakota, Grand
Forks, ND, USA
8
Department of Marine and Ecological Sciences, Florida Gulf Coast University,
Fort Myers, FL, USA
9
Department of Biological Sciences, California State University, Chico, CA,
USA
The Mercury Roundtable at the second meeting of the new International Society of
Environmental Bioindicators gathered human health, wildlife, and molecularly
focused researchers to evaluate the current status of mercury bioindicators. Our goal
was to identify a set of indicators, possibly in a tiered approach, suitable for both
developed and developing countries, across species (humans, wildlife, rodents) using
consistent methods so that the results are comparable over a period of time. The most
commonly used indicator of Hg exposure in both humans and wildlife is Hg tissue con-
centrations. Few bioindicators of effect have been validated for use in both human and
wildlife populations, but endpoints that focus on brain development and brain and
reproductive function are used in both humans and wildlife, and in both individual and
population level evaluations. Endpoints that may be most publicly and politically per-
suasive include impotence, autism, and cerebral palsy with mental retardation. We
recommend additional indicators be used in common across human and wildlife popu-
lations. Co-contaminant residues need to be evaluated in tissues, especially selenium,
as toxicity is related to the Hg:Se ratio. Further, more species need to be evaluated for
the genetic polymorphism (in CPOX4) that leads to a unique Hg-associated peak
(iso-keto-porphyrin) in porphyrin profiles in humans and a few non-human species.
Introduction and Summary Statement

Mercury is a ubiquitous environmental contaminant that is present in all environmental
media and has contaminated ecosystems worldwide. Mercury is the shape-shifter of toxi-
cants. Known to the ancient Greeks as the symbol of changeability, mercury’s several
chemical forms each have a different mode of toxic action. Similarly, the many purposes
for which mercury is used, and the variety of ways it enters ecosystems, carry with them
quite diverse exposure modes for humans and other organisms. Among the earliest
recorded toxicities of mercury was the exposure of hat makers to mercurous nitrate, used
in curing felt. Victims, such as the Mad Hatter in Lewis Carroll’s Alice in Wonderland,
developed muscular tremors, visual distortions and confused speech. Long-term occupa-
tional exposures to elemental mercury vapors, which can be absorbed through the lungs,
affected the nervous system resulting in tremors, headaches, short-term memory loss, inco-
ordination, sensory alterations and eventual psychiatric manifestations. Inorganic mercury,
the form to which workers in chloralkali plants are exposed, targets the kidneys, as well as
the nervous and reproductive systems. The form of mercury to which most Europeans and
North Americans are exposed is methyl-mercury, which is produced in the sediment of
aquatic systems by sulfate-reducing bacteria principally after atmospheric deposition.
Once methylated, this form of mercury is transferred through marine and aquatic food
chains and bioaccumulates to the highest concentrations in upper trophic-level animals and
humans, a process known as biomagnification. The developing nervous system is particu-
larly sensitive to methyl-mercury (USEPA 1997 a,b,c; Spiegel and Veiga 2007).
Recent estimates of total global mercury emissions from all sources — both natural
and human-generated — range from roughly 4,400 to 7,500 tons per year. In the United
States, mercury is the most commonly cited contaminant, causing fish advisories on water
bodies, both lakes and rivers. The primary source of mercury in the United States and
New Bioindicators for Mercury 185
other industrial countries is airborne mercury emissions released from combustion of coal
and mercury-containing products. Outside Europe and North America, an emerging form
of mercury hazard occurs among artisanal miners who participate in small-scale methods
of extracting gold from low concentration deposits (such as tailings left by industrial min-
ing operations or naturally deposited not-easily-extractable sediment sources). In this cot-
tage industry, elemental mercury is used to separate the gold from the tailings or sediment,
producing amalgam from which the mercury is then burned off in the open air or, even
more dangerously, in a small room. This practice contaminates the environment, including
large riverine systems in the Amazon (among other places), and exposes the miners and
the amalgam burners to high doses of airborne mercury (e.g. Boischio and Henshel, 2000;
Feng et al. 2006).
Research on mercury, its movement through ecosystems, and its effects on organisms
has progressed rapidly during the last several decades with approximately five thousand
articles published in peer-reviewed journals since 1980. This impressive output has been
the work of three quite distinct cohorts of investigators, human health researchers who
have tended to work with human populations from a combined epidemiological and case-
controlled study perspective, the wildlife and aquatic researchers who have evaluated
mercury-affected populations in the wild, and the researchers who focus on evaluating
molecular mechanisms and the cellular and subcellular interactions of mercury. As the
three sets of investigators tend to meet at different conferences and do not typically inter-
act, we intentionally brought representatives of all three groups together for the First Bien-
nial Mercury Bioindicators Roundtable at the second meeting of the International Society
of Environmental Bioindicators (ISEBI) held in Linthicum Heights, Maryland in April
2006. The Mercury Roundtable is planned as a biennial event at the ISEBI international
meetings.
Bioindicators
Bioindicators are quantifiable or indexable biologically based measures that can be used
to assess the function and functionality of a biological system (Bartell 2006). Within envi-
ronmental and toxicological sciences, bioindicators can be used to evaluate ecosystem sta-
tus, potential health effects, and potential population level impacts of an existing
environmental stressor. Biomarkers are a smaller subset of the bioindicators, being the
sub-organismal changes that occur in response to stressors that could be useful in predict-
ing the organismal level symptoms and severity of toxicity and disease. Biomarkers also
may include changes in behavioral responses in some paradigms. Because biomarkers are
typically changes in response to the stressor, measurements of the stressor itself, such as
concentrations of a toxic chemical in the target organism, are better considered part of the
superset of bioindicators than biomarkers. Bioindicators also include the identification of
indicator species that can be used, like the canary in the coal mine, as a warning of poten-
tial toxic exposures to other species in the same or a related exposure situation. Bioindica-
tor species have typically one or more of the following attributes: 1) being towards or at
the more sensitive end of responsiveness to the stressor or stressors of concern; 2) model-
ing similar attributes and responses compared to other potentially exposed species; 3)
being a federal or state/provincial protected (endangered or threatened) species; 4) being a
commercially important species.
Bioindicators and biomarkers, ideally, are predictive of an organismal or population
level effect, relatively inexpensive, methodologically portable between investigators and,
for greatest usefulness, between field and laboratory. In addition, in order to be most useful
186 Henshel et al.
in less developed regions, ideal biomarkers are technologically adaptable to less complex
equipment (Burger 2005). For example, a portable behavioral test of fine motor ability
involves putting small objects into smaller and smaller holes. This neurobehavioral assess-
ment can be carried out using rice or corn or an alternative local resource and putting the
individual grains in different sized holes carved out of a piece of wood. Bioindicators and
biomarkers can be very chemical or stressor specific, such as the inhibition of cholinest-
erase by the organophosphate and carbamate pesticides, or can be a measure of a common
effect endpoint, such as oxidative stress, that is similarly altered by multiple contaminants.
Roundtable Focus
The ultimate goal of this first roundtable was to identify a set of bioindicators, effectively
a toolbox, possibly in a tiered approach, that can be used in many locations (first and third
world), across many species, using consistent methods so that the results are comparable
over a period of time. These indicators would enable both short-term health and impact
assessments for specific risk management decisions, and long-term evaluation for regula-
tory and policy decision-making. The initial questions used to frame the roundtable dis-
cussion, and all of the participants’ presentations, are presented in Box 1. The goal in
developing this set of indicators as a toolbox is that each indicator be designated as appro-
priate for universal use or for selective use in appropriate situations. Briefly, key issues to
consider when establishing this toolbox include scale (ranging from molecular to land-
scape), logistical use considerations (are they highly technical or costly or low tech and
relatively inexpensive?), applicability across the different forms of mercury, applica-
bility across species, applicability for interpretation (as indicators of exposure, effect
or susceptibility), and relevance to risk communication and outreach efforts (the per-
suasiveness of the indicator to the general public and policy-makers). The scale issues and
how the experience of each presenter and invited participant matched the scale consider-
ations are summarized in Figure 1 and Table 1.
Roundtable Summaries
During the roundtable the invited speakers presented a short talk, summarized below and
logically arranged from molecular scale to population/landscape scale, followed by a dis-
cussion of the information among the panelists and audience members. On the second day,
the discussion focused on developing a set of recommendations aimed at managers and
policy makers with a secondary goal of recommending future experiments and studies to
be adopted by both research funders (for future Requests for Proposals) and researchers
already studying mercury-exposed populations. These final discussions produced the rec-
ommendations listed above, and other important points from this discussion are included
in the Summary Recommendations paragraph below.
Michael Aschner
“Selected Molecular Mechanisms of Methyl-Mercury-(MeHg)-Induced Neurodegeneration.”
The generation of reactive oxygen species (ROS) begins with univalent transfer of an
unpaired electron to O2, yielding ·O2−. Some ROS, including ·O2−, H2O2, ·NO, and
ONOO− are important signaling molecules that regulate cell function. There is also a
growing body of evidence to implicate an excessive or inappropriate generation of ROS in
neuropathology (reviewed by Heales et al., 1999). Potential sources of ·O2− in the CNS
Box 1. EBI Mercury Roundtable 2006 Starting Discussion Points

1. Many different types of bioindicators exist to assess the risk of mercury. These
include indicators of exposure (residue analysis), effect (from molecular through
behavior and population), and susceptibility (primarily genetic). However, residue
analysis may not have any “biological meaning” while behavioral tests may prove
that irreversible harm has already occurred. Ideally, indicators could be identified
that are relatively specific to Hg, useful across a broad range of species, including
humans, and logistically feasible to measure in a wide array of circumstances.
Given the array of indicators now in use or being evaluated, how do we decide
which indicator should be used? Will this be dictated by costs? Ease of applicabil-
ity? Relevance to the particular situation? How much more work is required to vali-
date indicators at the different levels of biological organization, and how can we
better integrate the indicators from different levels? Are there certain indicators
which would be more effective with increased research? Can we provide a list of the
key Hg bioindicators at each level of organization, and how they can be used?
2. Mercury species are highly reactive towards protein thiols which are ubiquitous in
all cells. As such, multiple cellular pathways remain viable targets for mercury toxi-
cosis, and the development or discovery of a single pathognomic marker is highly
unlikely. Given this, how might a suite of Hg exposure-effect endpoints be con-
structed to evaluate the molecular/cellular effects (is this the correct approach? What
research is needed to better understand the mechanisms that underlie Hg toxicity?
3. Mercury exists in 3 primary allotropes that have varying chemical and physical prop-
erties - elemental, organic and inorganic ions. The form of mercury has significant
effects on the toxicokinetics and toxicodynamics of mercury, from the molecular/cel-
lular level all the way to its fate and transport in the ecosystem. Given such a com-
plexity, how do we best assess the risks associated with elemental, organic and
inorganic mercury? Should they be treated separately? Do we know what the ulti-
mate toxicant (Hg2+ or MeHg) is for each effect? Furthermore, occupational/dental
exposures are primarily to inorganic or elemental mercury, while fish-eaters are typi-
cally exposed more heavily to MeHg? Should these risks be evaluated separately, or
can we develop a framework for integrating the risks to Hg in all of its forms, given
that they are changed from one to the other both in the body and in the environment?
4. Numerous factors can affect the toxicological actions of mercury, and these need to
be considered. Various nutritional factors, such as vitamin E and selenium, and co-
contaminants (with concomitant, prior or subsequent exposures), such as PCBs and
pesticides, are known to alter the toxicity of mercury. How do we distinguish these
effects in a real world situation? How will co-exposure affect exposure-effect out-
comes? Furthermore, fish consumption represents the primary route by which
humans and wildlife are continuously exposed to mercury, but fish may contain other
contaminants and a wealth of nutrients. How do we balance the risk and benefits?
5. What are the similarities and differences between humans and wildlife that are poi-
soned by mercury at ecologically relevant levels and at toxic doses? What data is
interchangeable between these two groups, and what are the limits/uncertainties in
such extrapolations? Can data accrued from ecological and wildlife species be used
to better protect humans from mercury risks? Can long-term monitoring programs
with wildlife be of use to human and ecological health realms?
(Continued)
188 Henshel et al.
Box 1. (Continued)
6. What bioindicators are now observable at the population level? Are they being
observed in animals, humans or both? Logistically, can these bioindicators be used
broadly, and tested against a broader range of populations, to ascertain their gen-
eral usefulness? What logistical considerations need to be taken into account
before these indicators can be used for different populations?
7. The biogeochemical cycling of mercury is very complex and is influenced by a
range of biological, chemical, and physical factors. Organisms that inhabit certain
ecosystems (i.e., wetlands, acidic ecosystems, reservoirs) are more at risk for Hg
accumulation, but the precise mechanisms underlying these observations are not
clearly understood yet. Should we focus research on at risk areas? Do we clearly
know why these areas are particularly at risk? Is it better to assess mercury effects
in these regions using population-level approaches, or individual assessments?
How does this biogeochemical cycling affect where and how organisms in the eco-
system are exposed to and absorb/ingest Hg (in which ever form)? How does the
similar metabolic cycling and binding to specific tissues within organisms simi-
larly affect exposure to organisms at higher trophic levels? What are the implica-
tions of these cycling phenomena and food chain exposures for which
bioindicators are most useful in developing a framework for Hg risk assessment
and risk management?
8. Hg changes over time both in the environment and in the body. These changes
can be associated with environmental fate and transport and with toxicokinetic
phenomena. Further, the effects of Hg may change over time, with increased
exposure and accumulation, as well as due to the induction of secondary toxi-
cological/biological impacts through the body (the ripple effect of any primary
effect). How do we incorporate these time factors into any framework
guidance developed to identify the optimal bioindicators to use in different
situations?
9. What type of monitoring and detection programs currently exist for mercury?
Which programs, and which aspects of these programs, could be used in other
developed nations and which can be used in developing nations? Can other devel-
oped and developing nations afford similar monitoring programs, and are there
indications that these programs will be supported by the government(s)? What are
the main criteria to focus on when setting up a monitoring program? Most pro-
grams rely on measuring Hg levels in fish – does this provide sufficient evidence
for reasonable decisions to be made using the risk assessment process? Is it possi-
ble to develop cost-effective biomarkers of effect?
10. In the end, science needs to serve and provide sufficient information for pol-
icy. Which bioindicators are most useful in informing policy decisions?
Which bioindicators can be developed for this purpose, and what research still
needs to be done? How do bioindicators fit into a risk management frame-
work, whether it is based on risk assessment or on the precautionary principle
(as is used in the EU)? What information is needed to inform policy develop-
ment/education/risk assessment? How are these answers different for North
America vs the EU vs Asia vs other parts of the world, especially the develop-
ing world?
Figure 1. Algorithm illustrating the multi-tiered bioindicator approach useful in evaluating mercury
risk. This algorithm integrates bioindicators across scales and between human health, laboratory
models and wildlife assessment approaches, and indicates the types of bioindicators that are most
effective in helping the public understand human health and ecosystem risk associated with expo-
sure to mercury. As the indicators move to a lower biological organizational level, the feasibility,
reproducibility and precision of the results increase. As the indicators move to a higher organiza-
tional level (towards the ecosystem level), the cost and time needed to assess the indicator increases,
as does the overall ecological relevance and the public persuasiveness.
Table 1
Mercury bioindicator expertise of roundtable participants
Indicators Panel Expert Examples
Exposure Basu, Bowerman, Tissue Residues, Hair and
Henshel, Ralston, Blood Levels
Rumbold, Shortelle
Molecular Sensitivity Aschner, Echeverria, Microtubules, Calcium
Ralston Homeostasis, Molecular
Markers, Polymorphisms
Cellular and Mechanistic Aschner, Basu, Henshel, Neurotransmission, Oxidative
Ralston, Wolfe Stress, Biochemical Changes
Organismal and Functional Echeverria, Henshel Various neurobehaviors and
pathologies
Population Bowerman, Echeverria, Disease morbidity, Population
Gilbertson, Ralston Declines
Ecosystem Ralston Environmental Fate, Habitat
Changes
190 Henshel et al.
include NOS, COX, lipoxygenase, NAD(P)H oxidase, xanthine oxidase, and mitochon-
dria (Cai et al., 2000). NOS-dependent ·O2− formation has been implicated in multiple
neuropathological conditions. The dominant effect of increased ROS production by astro-

cytes appears to be an attenuation of ·NO signaling by ·O2−. Studies suggest that inactiva-
tion of ·NO by ·O2− contributes to impaired cell function and that ·O2− scavengers are
effective in restoring optimal cell function (Rubanyi and Vanhoutte 1986; Tarpey and Fri-
dovich 2001; Didion et al. 2002). Local cellular levels of ·O2− reflect both the rate of ·O2−
formation and the rate of its removal by endogenous antioxidants [primarily superoxide
dismutases (SODs) and GSH). GSH is an important intracellular antioxidant in astrocytes.
Reduced GSH can react with reactive nitrogen species (RNS) and hence can limit mito-
chondrial damage. The reactions of RNS with GSH provide a mechanism to explain the
loss of cellular GSH that can occur following ·NO exposure. Furthermore, these reactions
will divert RNS away from critical cellular targets, such as the ETC, thereby explaining
why GSH status appears to be so critical in dictating susceptibility to ·NO and ONOO−.
Loss of GSH may be an important factor in the neurotoxicity associated with excessive
·NO formation and mitochondrial damage (Bolaños et al. 1996; Heales and Bolaños
2002).
While MeHg is known to induce oxidative stress, it has yet to be determined whether this
is due to a change in the balance of ·NO and other ROS. Studies on molecular teratogenic
mechanisms of MeHg in early developing rat embryos have noted significant induction of
iNOS mRNA and protein as potential mechanisms of aberrant neurulation (Li et al. 1998).
In mature rats MeHg treatment results in significant increases in nNOS activities in the
cerebrum and cerebellum, notably two areas that are preferentially affected in the adult
animal (Shinyashiki et al. 1998). MeHg causes ROS generation in nerve cells (Sarafian
and Verity 1991; Sarafian et al. 1994) and MeHg exposure in vivo elevates ROS in brain
regions sensitive to MeHg, but not in regions less sensitive to MeHg (LeBel et al. 1990,
1992). Consistent with the oxidative stress findings above, our studies in cultured primary
rat astrocytes suggest that a multitude of MeHg effects (cell swelling, glutamate release,
inhibition of glutamate uptake) can be attenuated by antioxidants (Mullaney et al. 1994;
Allen et al. 2001), whilst astrocytes depleted of GSH or those isolated from metallothion-
ein knockout mice (MT-/-) are significantly more sensitive to the effects of MeHg (Yao
et al. 1999, 2000).
Diana Echeverria
“Brain Derived Neurotrophic Factor (BDNF) and Coproporphyrinogen Oxidase
(CPOX4) Polymorphisms, and Associations with Behavioral Performance in a Mercury-
Exposed Dental Population.” Brain-derived neurotrophic factor (BDNF) is a protein pro-
duced by a gene on chromosome 11. It is a pro-survival factor that regulates survival of
striatal neurons. A val66met polymorphism [a single (val-met) or a double (met-met) sub-
stitution] supresses secretion of BDNF. Met-allele substitutions may reduce hippocampal
activation during encoding and retrieval of items in a memory task using functional mag-
netic resonance imaging (Egan et al. 2003). This allele substitution in the BDNF gene
accounts for 25% of the total variation in recognition memory and provides a specific
genetic mechanism that could explain substantial normal variation in human declarative
memory.
Elemental mercury exposure also has been associated with similar CNS effects, par-
ticularly short-term memory loss, depression, anxiety, and attention deficits, as well as
deficits in motor function expressed in at least one set of tests as reduced finger speed and
decreased fine motor coordination. Coproporphyrinogen oxidase (CPOX4) is a polymorphic

gene in humans that modifies the effect of Hg on a biological process of heme-pathway
synthesis in the kidney. Enzymes coproporphyrinogen oxidase and uroporphyrinogen

decarboxylase (CPOX and UROD) increase excretion of coproporphyrin [4-CP] and pen-
tacarboxyporphyrin [5-CP] by Hg in the kidneys. But 15% of exposed groups have greater
than expected excretion of 4- and 5-carboxyl porphyrins and the atypical ketoisocopropor-
phyrin (KICP). This subpopulation has a polymorphism in the CPOX gene. By inhibiting
the 5- to 4-decarboxylation step of UROD, Hg promotes 5-CP accumulation, accounting
for excess excretion in Hg-exposed subjects carrying a variant CPOX gene (CPOX4;
Woods et al., 1993; Woods, 1996), and 61% of those with the CPOX4 polymorphism are
more sensitive to the adverse effects of Hg exposure, and this difference can be observed
and quantified using neurobehavioral testing parameters (Heyer et al, 2006). Different
behavioral tests will give different responses, and many different types of tests have been
used including tests for attention, visual spatial sense, and motor, memory and sensory
tests. These last tests underlie the process of thinking which cannot be evaluated objec-
tively. From a holistic analysis, all the tests point to cognitive/motor effects due to mer-
cury exposure.
In this set of studies, we compared dental hygienists and dentists using the Behav-
ioral Evaluation for Epidemiological Studies (BEES) Test Battery. Mercury exposure
was estimated using spot urinary samples, and DNA was evaluated using buccal cell
scrapings. Epidemiologically these groups are different due to such factors as education,
history income, and vocabulary, although we observed no significant differences
between the groups in control tests not known to be sensitive to Hg. Noticeably, there
were subtle significant effects on measures of visual memory and hand steadiness that
were related to Hg exposure, and there was no apparent threshold for this effect on hand
steadiness. There was a clean dose response in motor function vs. the log of mercury
exposure, and measures of mood were also very sensitive to Hg concentrations (r2 =0.55;
25% variance).
BDNF-related effects included pattern memory, attention and finger tapping, while
CPOX polymorphism-related effects include vigilance, pattern discrimination and finger
tapping. These effects are additive, but not synergistic. Thus the presence of one of the
polymorphisms combines with mercury exposure results in greater behavioral changes.
Although these studies were carried out in dentists and dental assistants, who have some-
what higher mean Hg exposures than the general public, these changes are sensitive
enough and the general population is homogenous enough to detect subtle performance
shifts due to Hg exposure so long as there is sufficient statistical power in the study design
to detect behavioral deficits at very low levels of exposure (< 3 :g/ml).
Niladri Basu
“Utility of Neurochemical Biomarkers to Assess the Risks of Mercury to Wildlife.” Mon-
itoring changes in brain neurochemistry represents a method to assess the sub-clinical
effects of Hg (Manzo et al. 1996). Neurochemical studies on humans and laboratory
rodents have shown that Hg can significantly alter neurochemical pathways prior to the
onset of overt neurobehavioral damage. Such results suggest that changes to certain bio-
chemical receptors, enzymes, and transporters in the brain are good indicators of early
Hg damage. We have recently extended this approach to fish-eating wildlife as they bio-
accumulate appreciable quantities of Hg in their natural habitat and suffer ill health
effects.
192 Henshel et al.
In vitro experimentation on brain tissues isolated from wildlife allow the direct inter-
actions between Hg and neurochemical parameters to be assessed. In a comparative study,
we showed that inorganic and organic Hg inhibited ligand binding to the muscarinic
cholinergic receptor in the cerebral cortex and cerebellum brain regions of mink, river
otters, humans, rats and mice (Basu et al. 2005c). In a follow-up study, we found that
Hg-inhibited receptor binding to the muscarinic cholinergic receptor in ringed seal brain
samples but organochlorines (p-p’-DDT, Arochlor 1254, chlordane, dieldrin, lindane, and
toxaphene) did not (Basu et al. 2006a). Inorganic mercury, but not organic mercury inhib-
ited ligand binding to the NMDA receptor in several brain regions of mink (Basu et al.
2007c). High concentrations (100 uM) of inorganic and organic mercury inhibited the
activity of glutamic acid decarboxylase but not D2 receptor binding in mink brain (Basu et
al., unpublished results). Collectively, these results show that in vitro approaches can be
used to determine which aspects of neurochemical signaling (i.e., enzyme activity, recep-
tor binding, neurotransmitter uptake) are directly impaired by Hg. Such information can
be used to interpret in vivo responses, develop specific biomarkers, and to better under-
stand the cellular mechanisms that underlie Hg toxicity.
Having determined that Hg can impair a range of neurochemical systems, ecological/
correlative studies were carried out on wild-trapped animals to relate bioaccumulation of
Hg with neurochemical changes. In a cardinal study, a significant positive correlation was
measured between concentrations of Hg and levels of muscarinic cholinergic receptors in
whole brain samples of wild mink collected across Canada (Basu et al. 2005a). Positive
associations between mercury and muscarinic cholinergic receptor levels were also found
in brain tissues from wild common loons and bald eagles (Scheuhammer et al. 2007). For
the NMDA receptor, significant negative correlations were found between receptor levels
and brain mercury in wild mink (Basu et al. 2007c), common loons, and bald eagles
(Scheuhammer et al. 2007). Negative associations were measured between brain mercury
and dopamine-2 receptor levels in whole brains of wild mink (Basu et al. 2005a). In a
follow-up study on river otters, a significant negative correlation was measured between
these two parameters in the cerebral cortex region of the brain, but not in the cerebellum
(Basu et al. 2005b). Mercury-associated decreases in the activities of cholinesterase and
monoamine oxidase also have been found in the cerebral cortex of wild river otters (Basu
et al. 2007a). Activities of these neurochemical enzymes in river otters did not signifi-
cantly correlate with brain concentrations of polychlorinated biphenyls, organochlorinated
pesticides, and polybrominated diphenyl ethers (Basu et al. 2007b). These results clearly
show that ecologically relevant concentrations of Hg may be causing subtle neurochemi-
cal damage in a range of fish-eating mammals and birds.
Controlled dosing experiments on captive animals offer the most compelling evi-
dence for causal relationships. In 2004 a sub-chronic Hg and selenium feeding experiment
on captive mink was conducted at the Nova Scotia Agricultural College (Truro, Canada).
In brief, juvenile male mink were fed ecologically relevant concentrations of methyl-mer-
cury for 89 days (Basu et al. 2006b, 2007c). We found that exposure to 1–2 ppm of
methyl-mercury caused brain lesions in these animals (Lyn Ferns DVM, personal commu-
nication). Others have reported tissue lesions and neurobehavioral changes in captive
mink exposed to similar concentrations (Wobeser et al. 1976; Wren et al. 1987). At lower,
and ecologically relevant exposure levels (0.1 – 0.5 ppm MeHg), we found significant
changes in brain chemistry. Specifically, concentration-dependent increases in muscarinic
cholinergic receptor levels and cholinesterase activity were found in discrete brain regions
(Basu et al. 2006b). Methyl-mercury-related decreases in NMDA (Basu et al. 2007c) and
GABA receptor levels, and GABA-transaminase enzyme activity were also measured
(Basu et al. manuscript in preparation). These results established a continuum of Hg neu-

rotoxicity whereby accumulation of MeHg in the brain was followed by a suite of neuro-
chemical effects and ultimately structural and functional damage to the nervous system.
In conclusion, studies were conducted at multiple tiers of biological organization to
show that neurochemical approaches hold much promise to characterize the environmental
health effects of Hg on wildlife. By studying various organisms and neurological pathways,
it was found that certain neurochemicals (i.e., muscarinic cholinergic and NMDA receptors
in particular) may prove useful as bioindicators to assess the early health risks of Hg.
Nicholas Ralston
“Mercury:Selenium Ratio as a Bioindicator of Susceptibility to Mercury Bioaccumulation
and toxicity.” Selenium is the functional component of the 21st amino acid, selenocys-
teine, which is the biological form of selenium present at the active sites of selenoenzymes
which are normally present in all animal cells (Behne 2000). The functionally character-
ized selenoenzymes include four glutathione peroxidases, three thioredoxin reductases,
three thyroid hormone 5´deiodinases and selenophosphate synthetase. The glutathione
peroxidases and thioredoxin reductases are important in maintaining intracellular redox
status. Meanwhile, the thyroid hormone 5´ deiodinases convert T4 into T3 and regulate
amounts of active hormone. Selenophosphate synthetase is a selenoenzyme whose product
is essential for synthesis of all selenoenzymes, potentially making all of selenoenzyme
synthesis uniquely vulnerable to any insult that interrupts intracellular bioavailability of
selenium. Over half of all recognized selenoproteins are functionally uncharacterized at
present, but the highly conserved retention of their presence in brain and related tissues
indicates their roles may be crucial for normal neurophysiology. Many of the selenopro-
tein knockout models have been found to be embryonically lethal, indicating these pro-
teins perform essential functions (Bosl et al. 1997).
Unlike most amino acids, selenocysteine must be completely degraded and remade
during each cycle of selenoprotein synthesis. During each cycle, selenocysteine is degraded
to release selenide, the highest affinity mercury binding partner that is known to exist.
Since mercury binds the intracellular selenide that is required for de novo synthesis of sele-
nocysteine, mercury exposure impairs the formation of selenoenzymes, suppressing sele-
noenzyme activities in the brain and other organs. Since Hg effectively strips out available
Se by binding to the selenide ion, increasing Se relative to Hg would, logically, remove Hg
toxicity associated with suppression of selenoprotein activity. When tested, this has been
found to be the case. (Watanabe 2001; Watanabe et al. 1999a, 1999b). Compared to rats fed
diets containing 0.1 :mol Se/kg, rats fed 1 :mol Se/kg almost completely alleviated the
growth suppression induced by feeding 75 (mol MeHg/kg diet (Ralston 2005).
The Seychelles islands studies and the Faroe Island studies were conducted on two
populations chronically exposed to MeHg as a result of their high seafood consumptions.
Yet the results of these studies remain controversial as their findings initially appear to
contradict one another. The Faroe Island study conclusions were that MeHg exposure had
adverse developmental effects (Grandjean et al. 1997, 1998) at concentrations that were
not associated with harmful effects in the Seychelles Islands studies (Davidson et al. 1998,
2004; Myers and Davidson 1998). Previously neglected distinctions between the dietary
MeHg sources for these study populations appear to be a particularly important consider-
ation when comparing the results of these studies.
While both populations eat a lot of ocean fish, Faroe Islanders are known to include sig-
nificant quantities of pilot whale meat in their diets. Pilot whales are long-lived predators
194 Henshel et al.
that are very high in the marine food chain compared to most fish. As a result, pilot whales
bioaccumulate and biomagnify much greater loads of PCBs and MeHg than ocean fish
normally contain (Schantz et al. 1993). The total Hg content of pilot whale meat was
approximately 50 times higher than the total Hg content of the fish that are most com-
monly eaten in the Faroes (Grandjean et al. 1992). However, the distinctions in Hg:Se
molar ratios in pilot whale meat versus ocean fish meat appear to be the most important
difference between these seafoods.
When the relative concentrations of mercury to selenium (Hg:Se) are compared in
ocean fish, the ratio ranges from about 1:5 to about 1:25, depending on the species (Hall
et al. 1978). Meanwhile, in pilot whales the accumulated Hg is in substantial molar excess
of the Se, resulting in a hazardous and disproportionate ratio of about 4:1 (Juhlshamn et al.
1978). Therefore, the amount of Se present in the ocean fish diet of the Seychelles Island-
ers is more than enough to offset losses of Se to intracellular sequestration by Hg arising
from fish consumption, while the much higher molar quantities of Hg present in the whale
meat eaten by the Faroe Islanders is not offset by sufficient Se to compensate for the loss.
The high and disproportionate Hg:Se ratio characteristic of pilot whale meat could be con-
tributing to the harmful consequences of Hg exposure in the Faroe Islanders. Since expo-
sure to MeHg from consumption of ocean fish eaten by the Seychelles Islanders is far less
than the Se that is richly present, this may explain why no harmful consequences have
been noted (Raymond and Ralston 2004).
Regions with lower soil Se availability tend to observe higher fish Hg bioaccumula-
tion. These effects have been noted in the Florida Everglades, as well as in lakes in
Canada and Northern Europe. Moderate additions of Se to certain Swedish lakes have sig-
nificantly reduced (75% in 3 years) MeHg bioaccumulation in fish, although the mecha-
nism responsible for lowering MeHg in fish has not been determined (Lindqvist 1991).
Since Se modulates MeHg toxicity so effectively, it is important to measure Se contents
whenever Hg exposure is a toxicity concern. Future MeHg risk assessments will need to
take into consideration the Se status in the study populations.
Toxicity and risk assessment standards developed from studies done in areas where
Se status was rich or adequate will not be adequately protective in locations where Se is
poorly available. Low Se availability can occur as a result of its absence from parent mate-
rial of the region’s soils, but even where Se is present in soils, low pH can limit Se avail-
ability from soil. Furthermore, in lakes where chronically high Hg deposition has
cumulatively sequestered the Se that would otherwise be present, there may be a deficit of
biologically available Se. Fish in these lakes would be susceptible to accentuated MeHg
accumulation and the MeHg present in the low Se fish from these lakes will be more toxic
since they lack the protective effects of Se. Since freshwater fish in Se-poor regions will
tend to contain far less Se than ocean fish, risks of MeHg will be much greater. Such lakes
will need to be identified and will require development of location-specific standards. Fur-
ther research is needed to assess the toxicity of high MeHg exposures in the absence of
sufficient protective Se and to identify populations that may be at an increased risk.
Darren Rumbold
“The Efficacy of Monitoring Water-Column Concentrations and Loads of Total Mercury
and Methyl-mercury in Canals to Predict Body Burdens in Downstream Everglades
Fish”. In assessing either ecological or human health risks from mercury in the environ-
ment, the primary concern is the amount of methyl-mercury (MeHg) available for biomagni-
fication up the food chain. Corollaries to this are the fundamental questions regarding the
dominant proximate and ultimate sources (i.e., source of inorganic mercury for methyla-
tion) of this MeHg. A priori knowledge regarding source would allow for the development
of precise monitoring plans to alert environmental managers and regulators to potential

problems. However, uncertainty regarding proximate and ultimate source often leads to
extensive monitoring plans that attempt to track all potential fluxes to enable retrospective
source identification in the future, if biomonitoring reveals levels have increased.
One such monitoring program has been required in South Florida since the early
1990s. To address concerns regarding various construction activities in the Everglades
Protection Area, permits issued since 1994 by the Florida Department of Environmental
Protection to South Florida Water Management District (SFWMD) have required exten-
sive Hg monitoring in various media. In addition to monitoring ultra-trace, water-column
concentrations of total mercury (THg) and MeHg to assess compliance with state water
quality standards (WQS), the District is also required to monitor levels in sediment, rain,
fish tissues and bird feathers (for a description of program, see Rumbold et al. 2006).
Monitoring requirements have increased over the years to the point that currently the
SFWMD routinely collects quarterly water samples at 64 select control structures, making
this one of the largest ultra-trace mercury monitoring networks in the United States. This
network is expected to increase dramatically over the coming years with completion of a
large number of new projects.
To evaluate the efficacy of routinely monitoring water-column concentrations in sup-
ply canals, one of us examined the relationship between concentrations and loads of both
THg and MeHg in the canals and Hg levels in fish inhabiting downstream marshes. Loads
were calculated on a daily time step by multiplying estimated daily concentrations, based
on a linear interpolation between concentrations from quarterly sampling events, by esti-
mated daily flows. As of 2005, sunfish (Lepomis spp.) and largemouth bass (Micropterus
salmoides) were being collected annually for Hg analysis from 44 sites; at each site,
attempts are made to collect 20 each of sunfish and largemouth bass via electroshocking
methods.
Not surprisingly, tissue-Hg levels in the two contemporaneously collected fish spe-
cies were highly correlated (Table 2). Likewise, water-column concentrations and loads of
THg and MeHg were correlated (Table 2). Alternatively, this assessment found no mean-
ingful correlation between tissue-Hg in bass or bluegill and concentration of either THg or
MeHg in upstream canal (Table 2). The only statistically significant correlation between
Table 2
Spearman rank order correlation coefficients assessing relationship between
concentrations and loads of both THg and MeHg in southern Florida canals
and Hg levels in fish inhabiting downstream Everglades’ marshes
Bluegill Water- Water- Load of Load of
Tissue-Hg column column MeHg THg MeHg
Bass tissue-Hg 0.84* −0.50* −0.24 0.03 0.26
Bluegill tissue-Hg −0.24 0.04 0.09 0.27
Water-column THg 0.38* 0.27 0.21
Water-column MeHg 0.03 0.35*
Load of THg 0.83*
*Statistically significant at p < 0.05.
196 Henshel et al.
tissue Hg and water-column concentration or load was tissue-Hg in bass and water-col-
umn THg concentration in water; however, the negative coefficient suggested an inverse
relationship. Lack of correlation between tissue concentration in marsh fish and water-col-
umn concentration or load in the upstream canal may have been due to: 1) inadequate
monitoring in time or space resulting in a large time-step and inability to quantify load on
a per unit area basis (at most sites) or, 2) in situ methylation of fresh inorganic Hg in direct
rainfall being the primary driver for MeHg biomagnification in fish at a given marsh site
(i.e., as opposed to loading of THg or MeHg from upstream).
Expanding water-column monitoring in terms of spatial coverage and frequency of
collection would surely reduce uncertainty and might improve correlations; however, this
would be cost-prohibitive. Although the second possibility offered above cannot be
resolved solely on the basis of this assessment, there is a growing body of supporting evi-
dence in the form of biogeochemical mesocosm studies that suggests in situ production is
the primary driver in Everglades’ marshes, i.e., as opposed to loading of THg or MeHg
from upstream (Harris et al. 2003; Gilmour et al. 2004). Of course there will be other areas
within South Florida where in situ production of MeHg in sediments is low and, as a
result, MeHg loading from marshes upstream in the watershed will be the driver for bio-
magnification (e.g., lakes, rivers, estuaries) or where inorganic Hg in surface water
inflows is equally bioavailable for methylation as inorganic Hg in rain and thus could be a
driver. Unquestionably, we should continue to strive to reduce effluent loading to receiv-
ing waters of both THg and MeHg.
However, given there is a consensus that atmospheric loading is the dominant source
of THg to the Everglades (Stober et al. 2001; for review, see Atkeson and Parks 2002;
Rumbold et al. 2006) and that surface water concentrations of THg rarely exceed the WQS
(data not shown) and that neither THg or MeHg concentration or loads in upstream canals
are a good predictor of biomagnification in downstream fish, the question at hand is how
to best monitor Hg to alert us to potential problems. Based on this analysis, it is recom-
mended that we move away from routinely monitoring water-column concentrations and
rely more heavily on monitoring levels in fish. Any significant increase in Hg levels in
wild-caught fish would alert us to problem areas and the need to carry out expanded
follow-up sampling (including ambient and upstream surface water) for source identifica-
tion. This recommendation is consistent with the U.S. Environmental Protection Agency’s
(USEPA) fish tissue residue water quality criterion for MeHg (USEPA 2006).
William Bowerman
“Monitoring Mercury Exposure with Wildlife”. Wildlife are effective bioindicators of
exposure to concentrations of bioaccumulative contaminants. They are exposured to mul-
tiple chemicals over a broad spatial area, and provide evidence of the linkage between
environmental exposures and effects at local, regional, and global scales. A number of
examples are given here that will illustrate their utility to monitor mercury as well as give
examples that indicate that caution is necessary when attributing effects solely to mercury.
Bald eagles are one of the most studied birds in North America and are excellent bio-
indicators of both exposure and effect. As tertiary predators they biomagnify persistent
bioaccumulative compounds, including Hg. Tissues from these high-level predator spe-
cies can be used to monitor environmental concentrations. Mercury concentrations in the
tissues are indicative of environmental exposure and that the Hg is bioavailable. Changes
in tissue concentrations indicate changes in environmental concentrations. Tissues used
for biomonitoring can be collected non-invasively or from necropsied tissues. Understanding
the relationships between tissues or among species increases the overall utility of these
biomonitoring programs.
Predators of the aquatic food web are most at risk from lipophilic compounds that
biomagnify. Bald eagles are the top predators in many aquatic food webs. To monitor bio-
accumulation and biomagnification in the food web, one can use stable isotopes to better
understand aquatic food webs. Each prey species has a different composition of carbon
isotopes and nitrogen isotopes. Since “you are what you eat,” the prey isotope ratios can
be tracked through the food chain. The carbon isotope ratios do not change among trophic
levels, but do indicate whether the food web is based on C3 or C4 plants, indicating
aquatic or terrestrial based food webs. Nitrogen, however, increases between trophic lev-
els. Thus nitrogen isotopes can be used to determine trophic levels of predators and prey
since nitrogen increases by 3-5 per mil (‰) per trophic level.
For the Michigan Biosentinel Program, which has been ongoing now for over two
decades, our approach is to collect breast feathers and whole blood from nestling bald
eagles to measure Hg concentrations. Twenty percent of Michigan watersheds are moni-
tored each year so that the whole state is surveyed every 5 years. An outside Michigan
control area that we sample annually is Voyageurs National Park, Minnesota. Over time
and space we can compare concentrations across geographic scales (watershed to state-
level). Mean feather Hg concentrations in nestling eagles decreased by over 50% in
Voyageurs National Park (VNP), but changed only marginally in most sub-regions com-
paring 15 years ago (1984 – 1989) to the most recent sampling period (1999 – 2004).
These changes observed at VNP are attributed to stabilization of water levels by water
control structures over that time period and the subsequent decrease in mercury loading as
evidenced by concentrations in young-of-the-year yellow perch.
We also analyzed feathers of adult eagles from the Upper (UP) and Lower (LP) pen-
insulas in Michigan and VNP. Adult feathers were then sub-sampled to determine whether
there was differential uptake of Hg into different parts of the feathers (i.e., is there more in
the tip of the feather than in other parts of the feather grown over 1–2 months). Specifi-
cally the following three comparisons were assessed: rachis (the central feather spine) ver-
sus feather webbing, feather tip to other feather sections, adult feathers in three regions
(VNP, LP, UP). We found that the current method of using the tip of the feather was sup-
ported, and that VNP had the greatest mercury exposure for adult bald eagles. We also
found that no measure of reproduction for bald eagles was related to mercury concentra-
tion in adult or nestling feathers. On that note, it is important that one also conducts orga-
nochlorine residue analysis of tissues when trying to determine cause-effect linkages in
wildlife.
Berg et al. (1966) noted that sea eagles nesting along the Baltic Sea with 50 ppm Hg
in adult feathers had lowered reproduction. Other samples were also submitted to the ana-
lytical laboratories to measure exposure to organochlorine pesticides, but these data were
not available. Subsequently, a number of persistent, bioaccumulative contaminants
(including PCBs, organochlorine pesticides and Hg) were banned in the Baltic region.
After the ban, the organic chemicals (DDE and PCBs, in particular) decreased while Hg
levels did not, while eagle reproduction increased. The original relationship between Hg
and eagle reproduction was therefore not valid (Helander et al. 1982), with the reproduc-
tive effects caused in the environment by the organochlorine pesticides and DDE (see
Bowerman et al. 1995; Helander et al. 2002).
More recently we added a mink monitoring program in South Carolina and Louisiana.
For these studies we have been analyzing Hg concentrations in hair, liver, and brain and
have begun to compare the results between states and among tissues. Mink occupy a top
198 Henshel et al.
position in the food chain, and are thus exposed to environmental contaminants from a
variety of sources and are susceptible to biomagnified contaminants. Because of its com-
mercial value, mink are raised on commercial ranches in multiple states for their pelts.
Mink from two study areas were evaluated for Hg contamination: Acadia Parish, Louisiana
(LA) and South Carolina’s ACE Basin south of Charleston (SC). We were interested in
whether mercury exposure was different among mink from LA and SC, whether it made a
difference where hair was acquired from mink carcasses, and whether the relationship
observed in more northern regions where hair concentrations were predictive of tissue
concentratrions were valid for southern regions.
We found that body hair is also an effective non-invasive bioindicator of exposure for
animals, and specifically in mink, although there was no clear linear relationship between
Hg concentrations in hair and internal organ (liver, muscle) Hg concentrations from LA
and SC. Hg distributes and is deposited in body hair differentially in different parts of the
body, as the mercury concentrations in leg and neck hair were consistently higher than
those in back hair. Complicating the interpretation of the data, the Hg concentrations in
hair were apparently above the LD50 published in the literature, however the liver concen-
trations were below the NOAEL. Thus, it is important to be consistent in sampling tech-
niques and location of body hair used, and it is important to develop clear dose-response
relationships between exposure and effects for each of the bioindicator tissues. It must not
be taken for granted that relationships found in one geographic region (e.g., northern
regions of North America in the mink case) hold true for all geographic regions.
In summary, while wildlife are important indicators of exposures and effects of envi-
ronmental toxicants, caution must be taken in the interpretation of cause-effect linkages
attributing a single toxicant to the effect unless you have established what other com-
pounds are present. In addition, one must be cautious about interpreting relationships
among tissues unless you have established what those relationships are for your region
and ecotype, if the literature that developed that relationship is outside of your geographic
region and ecotype.
Michael Gilbertson
“Syndromic Surveillance of Congenital Minamata Disease in the Great Lakes: Need for a
Pathognomonic Biomarker.” There is over half a century of assessment of human
morbidity and mortality associated with methyl-mercury poisoning. In the 1950s, methyl-
mercury exposure in a small population surrounding Minamata Bay on the island of
Kyusho in Japan led to the identification of a suite of health effects that encompassed both
birth defects and other associated health effects (Harada 1978) that became known as con-
genital Minamata disease. In Iraq there have been several episodes of mass organic mer-
cury poisonings (1956, 1960, 1971–2) due to consumption of bread made from grain
treated with an organic mercury fungicide, although the last caused by far the greater num-
ber of deaths and morbidities (Bakir et al. 1973).
In the late 1960s, Fimreite (1970a, b) discovered anthropogenic mercury in the
Canadian environment, and identified mercury chloralkali plants and pulp and paper man-
ufacturing as two critical sources. He identified several critical locations and subpopula-
tions including Lakes St. Clair and Erie (commercial fishing, Walpole Island reserve), the
English-Wabigoon river (commercial fishing, tourism-based fishing, White Dog/Grassy
Narrows reserves) and Lebel-sur-Quevillion (subsistence fishing, Cree populations). The
response of governments was to close the commercial and tourism fishing areas on Lake
Erie, Lake St. Claire and the English-Wabigoon system. A long-term project monitoring
Hg in native people in Canada was initiated and concluded that there was “no provable
direct clinical effects” of the Hg contamination in their bodies (Health Canada 1999),
demonstrating the extreme difficulty of unambiguously identifying, from clinical exami-

nation, disease outbreaks induced by chemicals in the environment. De Rosa et al. (2006)
have identified the need among Great Lakes communities for “syndromic surveillance” to
identify diseases that may have an environmental link.
As a result of this new awareness about environmental pollution with mercury, the
U.S. Senate (1970) held hearings in the Great Lakes basin which contributed to new legis-
lation and regulations. In 1972, the U.S. and Canada signed the Great Lakes Water Quality
Agreement and in the 1980s designated 42 Areas of Concern where long-term violations
of water quality had caused injury to health of fish, wildlife and humans. In 1989, Health
Canada initiated a Great Lakes Health Effects Program as part of the Canadian Govern-
ment’s commitment to the Agreement. One of the projects was to identify critical subpop-
ulations within the 17 Canadian Areas of Concern. Health Canada (1998) selected more
than 70 health endpoints that “might be related to pollution,” and generated health data
and statistics based on rates of mortality, morbidity as hospitalization and congenital
anomalies to compare with the equivalent rates in the rest of the province. One of the 70
health endpoints was cerebral palsy (ICD9 code: 343) because of its association with pre-
natal exposures to methyl-mercury (Choi 1989, World Health Organization 1990). Anom-
alously, fetal and infant males are more susceptible to the neurological effects of methyl-
mercury than females (Harada 1994, Marsh et al. 1987). Health Canada (1998) compiled
data and statistics on the rates of mortality and morbidity for cerebral palsy in the 17
Canadian Areas of Concern. Initial results indicated a high rate of cerebral palsy hospital-
ization in males in several Areas of Concern where large quantities of mercury had been
discharged (Gilbertson 2004). To reduce the uncertainties (Beck 1992) associated with
these initial results, I applied (Gilbertson unpublished PhD thesis 2006) the guidelines
(italicized below) developed by Hill (1965) and adapted for Great Lakes forensic toxicol-
ogy by Fox (1991).
In terms of probability, the Health Canada approach seems to have been successful in
obtaining sufficient cases, even in small communities, for the detection of statistically sig-
nificant differences in rates of hospitalization for cerebral palsy on a gender-specific basis.
There are useful aspects of specificity in that methyl-mercury is the only chemical risk fac-
tor linked to cerebral palsy and the only chemical risk factor associated with differential
neuro-developmental susceptibility on a gender basis. There are no temporal grounds for
believing that the communities with elevated rates of hospitalization for cerebral palsy
were potentially unexposed prior to the study period (1986–1992). There is a consistency
of these new findings in Great Lakes communities with other studies undertaken on other
populations, by other scientists, at other locations and at other periods of time. The new
facts cohere with the existing body of theory concerning the role of methyl-mercury in
relation to cerebral palsy pathogenesis and there are coherent pathways, sources (includ-
ing natural geological sources), and routes of exposure of Great Lakes communities to
methyl-mercury. There are plausible mechanistic interpretations of toxic action on neuro-
logical development at different levels of biological organization. There are, however, at
this time no data that have shown a dose-response relationship between cerebral palsy
hospitalization and mercury exposures in the 17 Canadian Areas of Concern. Analysis of
odds ratios has demonstrated the strength of association between Canadian communities
in proximity to the Great Lakes and hospitalization for cerebral palsy in both males (OR
3.93; CI 3.44 – 4.48) and females (OR 3.99; CI 3.45 – 4.61) and an association between
male hospitalization for cerebral palsy and the historic presence of chloralkali plants (OR
200 Henshel et al.
1.44; CI 1.18 – 1.75). Finally, the implicit prediction of Health Canada that Areas of Con-
cern with elevated mercury concentrations would have higher rates of cerebral palsy has
been affirmed.
In conclusion, the Health Canada data provide potentially useful indicators of excess
morbidity in areas of concern likely from exposures to pollution, and these data suggest
that there are epidemiological indications of several outbreaks of congenital Minamata
disease, reflected as elevated rates of male hospitalization for cerebral palsy in Canadian
Areas of Concern. The ambiguity of the clinical symptoms of congenital mercury poison-
ing indicates the need for evaluation of a biomarker, such as the disturbance of microtu-
bule formation (Sager et al. 1982), as a pathognomonic indicator of exposure, effects and
susceptibility.
Martine Wolfe
“Mercury in Artisanal and Small-scale Mining.” Artisanal and small-scale mining
(ASM) is a process for extracting ore from deposits that are too poor for industrial-scale
mining companies to process economically. As more rural workers in developing coun-
tries are forced to abandon subsistence agriculture, the economic incentive to turn to ASM
increases. Because ASM is unregulated and marginally legal at best, the numbers of peo-
ple engaged in this work and the impact on their health and the environment is difficult to
assess. The numbers of people pursuing ASM increased 20% between 1989 and 1999; the
Global Mercury Project (GMP) of the United Nation Industrial Development Organiza-
tion (UNIDO) recently estimated that there are 20–30 million small-scale miners in 55
countries, and that 80–100 people are dependent on this activity for their livelihood (http:/
/www.unido.org/doc/44254). As of 2004, an estimated 10 – 15 million people, including
4.5 million and 300,000 small children were engaged in artisanal and small-scale mining
just of gold. As the price of gold continues to rise, more workers and their families will be
exposed the hazards that ASM entails (Viega and Baker 2004).
The misuse of mercury in small-scale mining (~1000 tons per year, much supplied by
developed countries) has polluted thousands of sites, poses long-term health risks to both
human and animal inhabitants of mining regions, and contributes more than 10 percent of
the modern anthropogenic loading of mercury to the earth’s atmosphere (Spiegel and
Veiga 2005).
Mercury amalgamation of gold as used in ASM is inexpensive and easy to learn, so it is
likely to remain the preferred method of concentrating the gold. The amalgam is burned in
the open air so that miners and their families and communities often inhale air containing 50
times the World Health Organization’s maximum public exposure guidelines. In some par-
ticularly inefficient operations in South America, an estimated 2 grams of mercury are
released into the environment for each gram of gold recovered (Spiegel and Veiga 2005).
Amalgam tailings leach mercury into water bodies, where the mercury is methylated
by sulfur-reducing bacteria and enters the aquatic food chain. Upper trophic level fish
make up an important part of the diet in mining areas, thus exposing miners and their com-
munities, including pregnant women and small children, to MeHg’s deleterious effects on
the developing nervous system (Boischio et al. 1995; Boischio and Henshel 1996).
Because of the several routes of exposure, and the various chemical forms of mercury
which have different mechanisms of toxicity on different target organs, there is unlikely to
be a single biomarker, even a biochemical one, that can assess the impact of mercury on
artisanal mining workers. Therefore different biomarkers are needed for different expo-
sure modes or other endpoints of interest.
One feature of ASM that distinguishes it from mercury exposure in developed coun-
tries is the need for worker education, helping the miners and processors recognize the
risks of their activities, and then persuading them to adopt alternative or mitigating prac-
tices — hence, a biomarker of awareness or education.
Such a biomarker must reflect that efforts to change miner attitudes and behavior
have been successful, and therefore needs to take into consideration the particular local
cultures and concerns. Barriers to change are considerable:
Economic Incentive. In Indonesia, for example, a miner with 6th-grade education earns
1.5 million rupiah/month, the same as an entry-level civil servant with two years of uni-
versity education. There is a ready supply of replacement workers; when a miner becomes
ill from mercury exposure, he returns to his village and a younger relative will take his
place.
Legality. Artisanal mining is a “shadow ‘economy” — illegal, but sustained by paying of

bribes. Physical biomarker measurements that require identification, such as necessary for
samples that are collected for off-site analysis are less acceptable than immediate-results
methods. Ministries nominally in charge of safety code enforcement are often controlled
by monied interests and corruption.
Education Level. In Indonesia, literacy is 100% (to the 6th grade) whereas in Africa, may
be close to zero among miners.
Cultural. Debilitated workers are accepted with favor in their home villages where they
viewed as economic heroes. A “macho” attitude towards health risks prevails.
A biomarker of education or awareness will reflect the success of an education cam-
paign that is sufficiently persuasive to overcome all these barriers. For this purpose, we
have expanded the “biomarkers’” definition to embrace any measurable endpoint that pro-
duces a change in thinking or behavior leading to a reduction in Hg human exposure and/
or environmental deposition to mercury. Such a measure must provide economic advan-
tage to miners, or at least not require an economic loss, which will not be tolerated.
Mercury health effects are recognized but will not provide incentive for change unless bun-
dled with other current health concerns such as malaria, or diarrhea. So far, the most effec-
tive incentive to change has been the risk of mercury-induced impotence. When GMP
workers in Brazil tested several approaches, impotence risk was found to be very persuasive.
Roundtable Recommendations
In the end, the group succeeded in identifying a few initial bioindicators for the toolbox:
1. Mercury tissue residues are not fully interpretable without knowing selenium residues,
and thus all residue analysis must include a reporting of the Hg:Se ratio. This is a mea-
sure of exposure that has implications for both effects and susceptibility.
2. Other contaminants have similar effects to mercury, and thus other inorganic and organic
co-contaminants should also be quantified and considered in the effects evaluation.
3. As malnutrition can confound and exacerbate mercury poisoning, some evaluation of
trace essential element concentrations beyond that of selenium should be determined in
blood, tissue or exposure media (i.e. soil, sediment, food), especially when evaluating
202 Henshel et al.
mercury poisoning in developing countries or very poor sub-regions of developed

countries. This is important in predicting population level effects.
4. Tissue residue by itself is not sufficient for management and policy decisions, and some
set of effects should be measured in the affected population(s).
5. Recommended sensitive but not mercury-specific effects include indicators of neuro-
toxicity and cellular oxidative stress. Some neurotoxic endpoints, like visual field con-
striction, are relatively specific to mercury while others, like delayed developmental
milestones, are not specific to mercury. In a situation where mercury exposure is docu-
mented using tissue residue analysis, the demonstration of changes in these effects bio-
indicators provides a strong argument for adverse mercury impacts.
6. Porphyrins can be measured relatively non-invasively in blood and urine. Since por-
phyrin profiles reflect a relatively specific pattern in mercury-exposed individuals, and
this pattern is clearly different than the pattern induced by other environmental persis-
tent contaminants, including other heavy metals, porphyrins should be included as a
key effects bioindicator when evaluating mercury-exposed populations.
a. In some species (including humans and rats) ketoisocoproporphyrin (KICP) has
been identified as a unique metabolite (and a unique peak in the porphyrin profiles)
in mercury-affected individuals. As porphyrin profiles reflect a biological effect and
changes in porphyrins also cause other biological effects, the porphyrin profiles,and
especially the presence of the ketoisocoproporphyrin peak, is a unique bioindicator
that reflects both exposure and effect. And since the ketoisocoproporphyrin peak is
particularly expressed in individuals with a coproporphyrinogen oxidase (CPOX4)
defect, the ketoisocoproporphyrin peak is also a bioindicator of susceptibility to
adverse mercury effects.
7. CPOX4 polymorphisms by themselves, then, indicate the potential for an increased

sensitivity to Hg toxicity. CPOX4 polymorphisms have been observed in a number of
animal species, but needs to be assessed in many more, especially in wildlife.
8. Autism (in humans) has been linked to early thiomerisol exposure, and may be a per-
manent neurotoxic effect associated with developmental mercury exposure. An equiva-
lent animal model should be established, especially one that can be assessed in wildlife.
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Roundtable Discussion Groups Summary Papers: New Bioindicators for Mercury

Article in Environmental Bioindicators · September 2007

Diane S Henshel Sanjay Basu

William W Bowerman N. V. C. Ralston

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Roundtable Discussion Groups Summary Papers

New Bioindicators for Mercury Toxicological

DIANE HENSHEL,1 MICHEAL ASCHNER,2 NILADRI BASU,3

WILLIAM BOWERMAN,4 DIANA ECHEVERRIA,5

Introduction and Summary Statement

Box 1. EBI Mercury Roundtable 2006 Starting Discussion Points

neuropathological conditions. The dominant effect of increased ROS production by astro-

decreased fine motor coordination. Coproporphyrinogen oxidase (CPOX4) is a polymorphic

synthesis in the kidney. Enzymes coproporphyrinogen oxidase and uroporphyrinogen

(Basu et al. manuscript in preparation). These results established a continuum of Hg neu-

of precise monitoring plans to alert environmental managers and regulators to potential

demonstrating the extreme difficulty of unambiguously identifying, from clinical exami-

Legality. Artisanal mining is a “shadow ‘economy” — illegal, but sustained by paying of

mercury poisoning in developing countries or very poor sub-regions of developed

7. CPOX4 polymorphisms by themselves, then, indicate the potential for an increased

Human Exp Toxicol 26(2):213–220.

Egan M, Kojima M, Callicott J, Goldberg T, Kolachana B, Bertolino A, Zaitsev E, Gold B, Goldman D,

Eagles Haliaeetus albicilla in Sweden. Holarctic Ecol 5:349–366.

(Haliaeetus leucocephalus). Ecotoxicology. In Press.

Environ Health 40:235–246.

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