Trends in blood mercury concentrations and fish consumption among U.S. women of reproductive age, NHANES, 1999-2010.

BACKGROUND: Consumption of finfish and shellfish is the primary exposure pathway of methylmercury (MeHg) in the US. MeHg exposure in utero is associated with neurodevelopmental and motor function deficits. Regulations and fish advisories may contribute to decreased exposure to mercury over time. OBJECTIVES: Combine fish tissue mercury (FTHg) concentrations and 1999-2010 NHANES blood mercury concentrations and fish consumption data to investigate trends in blood mercury concentrations, fish consumption, and mercury intake in women of reproductive age. METHODS: Blood MeHg was calculated from the blood total and inorganic concentrations. Dietary datasets were combined to estimate 30-day fish consumption, then combined with FTHg concentrations to estimate mercury intake and mercury concentration in the fish consumed. Non-linear and logistic regression analyses were used to evaluate trends over time. RESULTS: Regression analysis found NHANES 1999-2000 to have higher blood MeHg concentrations than the mean of the later releases (p<0.0001) and a positive quadratic trend since 2000 (p=0.004). No trend was observed in fish consumption amount or mercury intake. A decreasing trend was found in the ratio of mercury intake to fish consumed (p=0.04). CONCLUSIONS: The analyses found blood MeHg concentrations in NHANES 1999-2000 to be significantly higher than the mean of the later releases. There was no trend in fish consumption amount across the study period. The analysis found a decreasing trend in the ratio of mercury intake to fish consumed, consistent with women shifting their consumption to fish with lower mercury concentrations.

Adult women's blood mercury concentrations vary regionally in the United States: association with patterns of fish consumption (NHANES 1999-2004).

BACKGROUND: The current, continuous National Health and Nutrition Examination Survey (NHANES) has included blood mercury (BHg) and fish/shellfish consumption since it began in 1999. NHANES 1999-2004 data form the basis for these analyses. OBJECTIVES: This study was designed to determine BHg distributions within U.S. Census regions and within coastal and noncoastal areas among women of childbearing age, their association with patterns of fish consumption, and changes from 1999 through 2004. METHODS: We performed univariate and bivariate analyses to determine the distribution of BHg and fish consumption in the population and to investigate differences by geography, race/ethnicity, and income. We used multivariate analysis (regression) to determine the strongest predictors of BHg among geography, demographic factors, and fish consumption. RESULTS: Elevated BHg occurred more commonly among women of childbearing age living in coastal areas of the United States (approximately one in six women). Regionally, exposures differ across the United States: Northeast > South and West > Midwest. Asian women and women with higher income ate more fish and had higher BHg. Time-trend analyses identified reduced BHg and reduced intake of Hg in the upper percentiles without an overall reduction of fish consumption. CONCLUSIONS: BHg is associated with income, ethnicity, residence (census region and coastal proximity). From 1999 through 2004, BHg decreased without a concomitant decrease in fish consumption. Data are consistent with a shift over this time period in fish species in women's diets.

Estimates of fish consumption rates for consumers of bought and self-caught fish in Connecticut, Florida, Minnesota, and North Dakota.

Fish consumption rates derived from national surveys may not accurately reflect consumption rates in a particular population such as recreational anglers. Many state and local health agencies in the U.S. have conducted area-specific surveys to study fish consumption patterns in local populations, assess exposure to environmental contaminants, or evaluate compliance with fish advisories. The U.S. Environmental Protection Agency (EPA) has analyzed the raw data from fish consumption surveys in Florida, Connecticut, Minnesota, and North Dakota for the purpose of deriving distributions of fish consumption rates and studying the variables that may be more predictive of high-end consumers. Distributions of fish consumption for different age cohorts, ethnic groups, socioeconomic statuses, types of fish (i.e., freshwater, marine, estuarine), and source of fish (i.e., store-bought versus self-caught) were derived. Consumption of fish and shellfish for those who consume both caught and bought fish is higher than those who reported eating only bought or only self-caught. Mean fish consumption per kilogram of body weight ranged from 0.11 g/kg-day to 2.3 g/kg-day. The highest values were observed in Florida for children 1<6 years of age. The Florida data show a statistically significant increase in the percentage of the population reporting fish and shellfish consumption with an increase in household income and education. This trend was not observed in the other states.

Methylmercury and omega-3 fatty acids: co-occurrence of dietary sources with emphasis on fish and shellfish.

Despite many claims of broad benefits, especially for in utero development, derived from the consumption of fish as a source of omega-3 fatty acids, individual species of fish and shellfish provide substantially varied levels of these fatty acids. Likewise, mean methylmercury (MeHg) concentrations for fish and shellfish species differ by greater than an order of magnitude. Consideration of within-species variability would increase this variation farther. Exposures to both MeHg and to the omega-3 fatty acids reflect dietary choices including species consumed, frequency of consumption, and portion size. In view of these sources of variability, data on dietary patterns and blood mercury (microg/L) among women of child-bearing age (e.g., 16-49 years) provided an indication of exposures in the United States. Utilizing data from the National Health and Nutrition Examination Survey (NHANES) for survey years 1999--2002, calculated consumption of MeHg and omega-3 fatty acids from fish and shellfish have been estimated based on results from 3614 women who provided 30-day dietary recall and 24-hours records. Statistics from NHANES when appropriately weighted are representative of the US population. The association between dietary MeHg from fish and shellfish and dietary fish intake yielded a Pearson correlation of 0.68. The Pearson correlation between estimated 30-day intake from fish/shellfish consumption for omega-3 fatty acids and MeHg was 0.66. Evaluation of the most commonly consumed fish and shellfish species as sources of MeHg and omega-3 fatty acids indicated that salmon followed by shrimp are principal sources of omega-3 fatty acids and are lesser sources of MeHg, in contrast with tuna which provides omega-3 fatty acids, but considerably higher levels of MeHg. These data can be used to guide selection of individual fish and shellfish species that are higher in omega-3 content and low in MeHg concentrations. This more refined dietary approach contrasts with generic recommendations that simply advise increasing fish consumption as a path toward improving cardiovascular health and providing benefits for in utero development or avoiding fish altogether.

Serum TSH and total T4 in the United States population and their association with participant characteristics: National Health and Nutrition Examination Survey (NHANES 1999-2002).

OBJECTIVE: Describe thyrotropin (TSH) and thyroxine (T4) levels in the U.S. population and their association with selected participant characteristics. DESIGN: Secondary analysis of data from the National Health and Nutrition Examination Survey (NHANES) collected from 4392 participants, reflecting 222 million individuals, during 1999-2002. RESULTS: Hypothyroidism prevalence (TSH > 4.5 mIU/L) in the general population was 3.7%, and hyperthyroidism prevalence (TSH < 0.1 mIU/L) was 0.5%. Among women of reproductive age (12-49 years), hypothyroidism prevalence was 3.1%. Individuals aged 80 years and older had five times greater odds for hypothyroidism compared to 12- to 49-year-olds (adjusted odds ratio [OR] = 5.0, p = 0.0002). ORs were adjusted for sex, race, annual income, pregnancy status, and usage of thyroid-related medications (levothyroxine/thyroid, estrogen, androgen, lithium, and amiodarone). Compared to non-Hispanic whites, non-Hispanic blacks had a lower risk for hypothyroidism (OR = 0.46, p = 0.04) and a higher risk for hyperthyroidism (OR = 3.18, p = 0.0005), while Mexican Americans had the same risk as non-Hispanic whites for hypothyroidism, but a higher risk for hyperthyroidism (OR = 1.98, p = 0.04). Among those taking levothyroxine or desiccated thyroid, the adjusted risk for either hypothyroidism (OR = 4.0, p = 0.0001) or hyperthyroidism (OR = 11.4, p = 4 x 10(-9)) was elevated. CONCLUSIONS: Associations with known factors such as age, race, and sex were confirmed using this data set. Understanding the prevalence of abnormal thyroid tests among reproductive-aged women informs decisions about screening in this population. The finding that individuals on thyroid hormone replacement medication often remain hypothyroid or become hyperthyroid underscores the importance of monitoring.

Blood organic mercury and dietary mercury intake: National Health and Nutrition Examination Survey, 1999 and 2000.

Blood organic mercury (i.e., methyl mercury) concentrations among 1,709 women who were participants in the National Health and Nutrition Examination Survey (NHANES) in 1999 and 2000 (1999-2000 NHANES) were 0.6 microg/L at the 50th percentile and ranged from concentrations that were nondetectable (5th percentile) to 6.7 microg/L (95th percentile). Blood organic/methyl mercury reflects methyl mercury intake from fish and shellfish as determined from a methyl mercury exposure parameter based on 24-hr dietary recall, 30-day food frequency, and mean concentrations of mercury in the fish/shellfish species reported as consumed (multiple correlation coefficient > 0.5). Blood organic/methyl mercury concentrations were lowest among Mexican Americans and highest among participants who designated themselves in the Other racial/ethnic category, which includes Asians, Native Americans, and Pacific Islanders. Blood organic/methyl mercury concentrations were ~1.5 times higher among women 30-49 years of age than among women 16-29 years of age. Blood mercury (BHg) concentrations were seven times higher among women who reported eating nine or more fish and/or shellfish meals within the past 30 days than among women who reported no fish and/or shellfish consumption in the past 30 days. Blood organic/methyl mercury concentrations greater than or equal to 5.8 microg/L were lowest among Mexican Americans (2.0%) and highest among examinees in the Other racial/ethnic category (21.7%). Based on the distribution of BHg concentrations among the adult female participants in 1999-2000 NHANES and the number of U.S. births in 2000, > 300,000 newborns each year in the United States may have been exposed in utero to methyl mercury concentrations higher than those considered to be without increased risk of adverse neurodevelopmental effects associated with methyl mercury exposure.

The prevalence of lead-based paint hazards in U.S. housing.

In this study we estimated the number of housing units in the United States with lead-based paint and lead-based paint hazards. We included measurements of lead in intact and deteriorated paint, interior dust, and bare soil. A nationally representative, random sample of 831 housing units was evaluated in a survey between 1998 and 2000; the units and their occupants did not differ significantly from nationwide characteristics. Results indicate that 38 million housing units had lead-based paint, down from the 1990 estimate of 64 million. Twenty-four million had significant lead-based paint hazards. Of those with hazards, 1.2 million units housed low-income families (< 30,000 US dollars/year) with children under 6 years of age. Although 17% of government-supported, low-income housing had hazards, 35% of all low-income housing had hazards. For households with incomes greater than or equal to 30,000 US dollars/year, 19% had hazards. Fourteen percent of all houses had significantly deteriorated lead-based paint, and 16% and 7%, respectively, had dust lead and soil lead levels above current standards of the U.S. Department of Housing and Urban Development and the U.S. Environmental Protection Agency. The prevalence of lead-based paint and hazards increases with age of housing, but most painted surfaces, even in older housing, do not have lead-based paint. Between 2% and 25% of painted building components were coated with lead-based paint. Housing in the Northeast and Midwest had about twice the prevalence of hazards compared with housing in the South and West. The greatest risk occurs in older units with lead-based paint hazards that either will be or are currently occupied by families with children under 6 years of age and are low-income and/or are undergoing renovation or maintenance that disturbs lead-based paint. This study also confirms projections made in 2000 by the President's Task Force on Environmental Health Risks and Safety Risks to Children of the number of houses with lead-based paint hazards. Public- and private-sector resources should be directed to units posing the greatest risk if future lead poisoning is to be prevented.

First National Survey of Lead and Allergens in Housing: survey design and methods for the allergen and endotoxin components.

From July 1998 to August 1999, the U.S. Department of Housing and Urban Development and the National Institute of Environmental Health Sciences conducted the first National Survey of Lead and Allergens in Housing. The purpose of the survey was to assess children's potential household exposure to lead, allergens, and bacterial endotoxins. We surveyed a sample of 831 homes, representing 96 million permanently occupied, noninstitutional housing units that permit resident children. We administered questionnaires to household members, made home observations, and took environmental samples. This article provides general background information on the survey, an overview of the survey design, and a description of the data collection and laboratory methods pertaining to the allergen and endotoxin components. We collected dust samples from a bed, the bedroom floor, a sofa or chair, the living room floor, the kitchen floor, and a basement floor and analyzed them for cockroach allergen Bla g 1, the dust mite allergens Der f 1 and Der p 1, the cat allergen Fel d 1, the dog allergen Can f 1, the rodent allergens Rat n 1 and mouse urinary protein, allergens of the fungus Alternaria alternata, and endotoxin. This article provides the essential context for subsequent reports that will describe the prevalence of allergens and endotoxin in U.S. households, their distribution by various housing characteristics, and their associations with allergic diseases such as asthma and rhinitis.