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AMAP Greenland and the Faroe Islands 1997-2001

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AMAP Greenland and the Faroe Islands 1997-2001 2003 AMAP Greenland and the Faroe Islands 1997-2001 Vol. 1: Human Health Editors: B. Deutch & J.C. Hansen DANCEA Danish Cooperation for Environment in the Arctic Ministry of Environment Contents PREFACE 7 INTRODUCTION 9 1 DANISH NATIONAL REPORT INTRODUCTION 11 1.1 MAJOR ACHIEVEMENTS IN THE INTERNATIONAL AND DANISH AMAP HUMAN HEALTH PROGRAMME DURING PHASE 2. 1.2 NEW RESULT.S 11 1.2.1 Monitoring of exposure: 11 1.2.2 Effects of exposure: 12 1.3 THE NATIONAL REPORT. 12 1.3.1 Greenland. 12 1.3.2 The Faroe Islands. 13 2 SOCIOCULTURAL ENVIRONMENT, LIFESTYLE, AND HEALTH IN GREENLAND 15 2.1 SETTLEMENT STRUCTURE 15 2.2 LANGUAGE AND CULTURE 16 2.3 LIFESTYLE 16 2.4 DISEASE PATTERN 17 2.5 HEALTH CARE 17 2.6 REFERENCES 19 3 CONTAMINANTS IN SUBSISTENCE ANIMALS IN GREENLAND 21 3.1 INTRODUCTION 21 3.2 METHODS 21 3.2.1 Sampling 21 3.3 RESULTS 22 3.3.1 Metals 22 3.3.2 Organochlorines (OCs) 24 3.4 REFERENCES 26 4 THE HUMAN HEALTH PROGRAMME IN GREENLAND 1997-2001 53 4.1 INTRODUCTION 53 4.2 METHODOLOGY BY PROJECT/STUDY GROUP. 56 4.2.1 Pregnant women and infants 1994-97 56 4.2.2 Pregnant women 1999-2001 57 4.2.3 Pilot study, Geographical distribution of contaminant burden, men from 5 districts in Greenland 1997 61 4.2.4 Cross sectional study Uummanaq 1999 62 4.2.5 Men and non- pregnant women East Greenland, 1999-2000. 65 4.2.6 Dietary Survey, pilot study, 1999 66 4.3 RESULTS BY PROJECT/ STUDY GROUP 67 4.3.1 Pregnant women and infants.1994-2001 67 4.3.2 Geographical study 1997 74 4.3.3 Men and non-pregnant women 1999-2000 76 4.3.4 Percentages of samples exceeding guidelines for blood levels of pollutants 84 4.3.5 Dietary Surveys 1999-2000 87 4.3.6 Associations between contaminants and other factors 98 4.3.7 Dietary exposure from local food items. 108 4.4 SUMMARY 118 4.4.1 Heavy metals 118 4.4.2 Organochlorines 118 4.4.3 Dietary Markers 119 4.4.4 Dietary surveys 119 4.4.5 Dietary exposure from contaminants 119 4.4.6 Predictors of high contaminant levels 120 4.4.7 Time trends. 120 4.5 REFERENCES 120 5 THE FAROE ISLANDS. SOCIOCULTURAL ENVIRONMENT, LIFESTYLE, HEALTH AND CONTAMINANT EXPOSURE 123 5.1 SETTLEMENT SRUCTURE 123 5.2 LANGUAGE AND CULTURE 125 5.3 LIFESTYLE 126 5.4 DISEASE PATTERN 126 5.5 HEALTH CARE 126 5.6 CONTAMINANTS IN FAROESE SUBSISTENCE FOOD 127 5.6.1 Heavy metals 128 5.6.2 POPs 131 5.6.3 Dioxins 132 5.6.4 Flame retardants 132 5.7 REFERENCES 132 6 THE HUMAN HEALTH PROGRAMME IN THE FAROE ISLANDS 1985-2001 135 6.1 INTRODUCTION 135 6.2 EFFECTS OF MARINE POLLUTANTS ON DEVELOPMENT IN FAROESE CHILDREN 136 6.2.1 Introduction 136 6.2.2 Methods 139 6.2.3 Results 145 6.2.4 Discussion 173 6.2.5 Conclusions 179 6.2.6 Summary 180 6.2.7 Appendix 181 6.3 DIETARY SURVEY OF FAROESE WOMEN IN THIRD TRIMESTER OF PREGNANCY 194 6.3.1 Material and Methods: 194 6.3.2 Results 196 6.3.3 Discussion: 199 6.4 EXPOSURE TO SEAFOOD CONTAMINANTS AND IMMUNE RESPONSE IN FAROESE CHILDREN 199 6.5 EXPOSURE TO MERCURY AND ORGANOCHLORINES 1985-2001. 199 6.5.1 Introduction 199 6.5.2 Mercury in maternal blood 200 6.5.3 Mercury in maternal hair samples 200 6.5.4 Mercury in umbilical cord blood 201 6.5.5 Mercury in breast milk 202 6.5.6 MeHg in hair in children 202 6.5.7 Mercury in children at age 7 years 202 6.5.8 PCB in maternal serum 203 6.5.9 PCB in cord blood 203 6.5.10 PCB in breast milk 203 4 6.5.11 Lead in cord blood 204 6.5.12 Selenium 204 6.5.13 Other contaminants in maternal serum 205 6.5.14 Other contaminants in breast milk 205 6.5.15 Contamination levels in two consecutive pregnancies 205 6.5.16 Influence of dietary recommendation 206 6.5.17 Diet during pregnancy 206 6.5.18 Comparison of contamination in Faroese and non-Faroese mothers207 6.5.19 Description of study populations 208 6.6 ACKNOWLEDGEMENT 209 6.7 REFERENCES 209 7 THE HUMAN HEALTH EFFECTS BIOMARKER PROGRAM213 7.1 INTRODUCTION 213 7.1.1 Endocrine disruption 215 7.1.2 Exposure to chemical mixtures 217 7.1.3 POPs, gene polymorphism and hormone metabolism 218 7.1.4 Effect on hormone receptor numbers 219 7.1.5 The AMAP Human Health Effects Monitoring Programme 219 7.2 METHODS 222 7.2.1 Determination of xenohormone activities in serum. 222 7.2.2 Determination of the sum of serum dioxin-like activities 222 7.2.3 Determination of estrogen metabolites in urine 222 7.2.4 Determination of inflammatory cytokines in serum 222 7.3 RESULTS 223 7.3.1 Determination of xenohormon and dioxin-like activities in serum samples 223 7.3.2 Measurement of cytokine levels in serum 224 7.3.3 Determination of the ratio of estrogen metabolites in urine 224 7.3.4 Genotyping and gene expression 224 7.4 DISCUSSION AND PERSPECTIVES 225 7.5 REFERENCES 225 8 CONCLUSIONS AND RECOMMENDATIONS 231 8.1 GENERAL CONCLUSIONS 231 8.2 GENERAL RECOMMENDATIONS. 232 8.3 SPECIFIC CONCLUSIONS 232 8.3.1 Conclusions from the AMAP, HH Programme in Greenland 232 8.3.2 Recommendations for Greenland 233 8.3.3 Conclusions and Recommendations from The Faroe Islands. 233 8.4 MAIN CONCLUSION 234 5 6 Preface The present report, is one of five National Reports on AMAP activities in Greenland and The Faroe Islands during phase 2, 1997-2002, published by the Danish Environmental Protection Agency. The scope of the report is to provide the fully referenced, comprehensive, technical and scientifically presented assessment of available and validated data on the Human Health status in Greenland and the Faroe Islands relative to the AMAP phase 2 mandate. This report provides a more comprehensive and detailed presentation of data from the two areas than what was possible to include in the international report. The report is specifically addressed to scientists in Public Health, Environmental Medicine, and others with interest in the Arctic Environment. Editors: Bente Deutch, Associate professor, Ph.D. MPH, Centre of Arctic Environmental Medicine, CAM, Vennelyst Boulevard 6, 8000 Aarhus C, Denmark, +45 8942 6172 Jens C. Hansen, Associate Professor, Dr.med. Centre of Arctic Environmental Medicine, CAM, Vennelyst ,Boulevard 6, 8000 Aarhus C, Denmark. +45 8942 6160 The following authors have contributed to the report: Chapter 1: Editors Chapter 2: Peter Bjerregaard, Professor, Dr.med., The National Institute of Public Health, Svanemøllevej 25, 2100 Copenhagen Ø, Denmark. Chapter 3: Poul Johansen, Ph.D., Gert Asmund, Ph.D., Rune Dietz, Ph.D. Department of Arctic Environment, the National Institute of Environmental Research, P.O. Box 358, Frederiksborgvej 399, 4000 Roskilde, Denmark. Derek Muir, Ph.D., Environment Canada, 867 Lakeshore Road, MNR3T 2NG Burlington, Canada. Chapter 4: Bente Deutch, Associate professor, Ph.D. MPH, Centre of Arctic Environmental Medicine, CAM, Vennelyst Boulevard 6, 8000 Aarhus C, Denmark Chapter 5: The chapter is in partly from Árni Olafsson: “The Faroe Islands, A brief introduction”, published by the Faroese Government Office, Copenhagen, 1999, and supplemented by Pál Weihe, MD, Depart. of Occupational and Public Health, The Faroese Hospital System, Sigmundargøta 5, P.O. Box 14, 110 Tórshavn, Faroe Islands. The part on Contaminants in Faroese subsistence food is by Maria Dam, Dr. Scient, Food and Environmental Agency, Falkavegur 6, Fo-100 Tórshavn, Faroe Islands. Chapter 6: Pál Weihe, MD, Ulrike Steuerwald, MD, PhD, MPH, Sepideh Taheri, MD, Odmar Færø, MD, Anna Sofía Veyhe, midwife, 7 Did Nicolajsen, dietician, Depart. of Occupational and Public Health, The Faroese Hospital System, Sigmundargöta 5, P.O. Box 14, 110 Tórshavn, Faroe Islands. Chapter 7: Eva Bonefeld Jørgensen, Associate Professor Ph.D. Unit of Environmental Biotechnology UEB), Dept. Environmental and Occupational Medicine, University of Aarhus, Vennelyst Boulevard 6, 8000 Aarhus C, Denmark. Chapter 8: Editors The Project has been followed by an advisory group with the following members: Peter Bjerregaard National Institute of Public Health, Copenhagen Arne Büchert Danish Veterinary and Food Administration, Copenhagen Anders Carlsen (Chair) Medical Health Officer Medical Office of health for Viborg County, Viborg Phillippe Grandjean Institute of Public Health University of Southern Denmark, Odense Jens C. Hansen Dep. of Environmental and Occupational Medicine Centre for Arctic Environmental Medicine, Aarhus University Elle Laursen (until 2002) National Board of Health, Copenhagen Ole Mygind (from2002) National Board of Health, Copenhagen Elsa Nielsen Institute of Toxicology Danish Veterinary and Food Administration Copenhagen Pal Weihe Medical Health Officer ,The Faroese Hospital System Tórshavn Hans Chr. Wulf Department of Dermatology Bispebjerg Hospital, Copenhagen The Map of Greenland has kindly been made available by “Greenland Statistics”. 8 Introduction At the Rovaniemi Ministerial meeting in 1991 it was decided to implement a programme to monitor the levels and assess the effects of contaminants in all compartments of the Arctic environment. Accordingly, between 1991 and 1996 the Arctic Monitoring and Assessment Programme, AMAP was designed and implemented as AMAP phase I. The first international assessment report was subsequently published (AMAP 1998). To fulfil the international requirements a specific Greenland AMAP programme was implemented and a Greenland Faroe Islands assessment report was produced (Aarkrog et al. 1997). The accomplishments of AMAP phase I were fully recognized by the Ministers.
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