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A descriptive analysis of blood mercury test results in British Columbia to identify excessive exposures
David A McVea1, Emma Cumming2, Tissa Rahim3
1University of British Columbia Public Health and Preventive Medicine Residency, Vancouver, BC, Canada.
Insights
Blood mercury testing in British Columbia revealed that adults over 50 were most frequently tested. Nine percent of women aged 19-49 exceeded guidance values, and follow-up testing was inadequate for many with high mercury levels.
Area of Science:
- Environmental Health
- Toxicology
- Public Health Surveillance
Background:
- Blood mercury testing is crucial for monitoring environmental exposure and potential health risks.
- Understanding testing patterns and results is essential for public health interventions in British Columbia.
Purpose of the Study:
- To characterize individuals tested for blood mercury in British Columbia.
- To analyze the distribution of blood mercury concentrations and identify results exceeding Health Canada's guidance values.
- To assess the adequacy of follow-up testing for elevated blood mercury levels.
Main Methods:
- Descriptive analysis of clinician-ordered blood mercury tests from BC laboratories (2009-2010).
- Statistical testing to determine testing rates, concentration distributions, and exceedance of guidance values.
- Examination of repeat testing patterns for individuals with elevated results.
Main Results:
- Adults aged 50 and older had the highest blood mercury testing rates.
- Nine percent of women aged 19-49 years exceeded the provisional guidance value of 8 μg/L.
- Only 45% of individuals with results exceeding guidance values in 2009 were re-tested within 12 months.
Conclusions:
- Provincial-level analysis of blood mercury testing aids in assessing follow-up adequacy and identifying high-exposure populations.
- Specific demographic groups and regions in BC show higher mercury exposure levels.
- Inadequate follow-up testing for elevated blood mercury requires public health attention.
Objective:
The objective of this study was to describe who in British Columbia (BC) is tested for blood mercury, the distribution of their results, and the adequacy of follow-up testing.
Methods:
The BC Centre for Disease Control (BCCDC) obtained records of clinician-ordered analyses of blood mercury conducted by BC laboratories during 2009 and 2010. We conducted a descriptive analysis with statistical testing of who was tested, the distribution of their blood mercury concentrations, whose results exceeded Health Canada's proposed guidance values (8 μg/L (40 nmol/L) for children/adolescents ≤ 18 years and women 19-49 years, and 20 μg/L (100 nmol/L) for other adults), and patterns of repeat testing.
Results:
Mercury test results for 6487 individuals were reviewed. Adults ≥ 50 years had the highest testing rates. The median blood mercury concentration for all tested persons was 1.8 μg/L. Nine percent of women aged 19-49 years had results exceeding Health Canada's provisional guidance value of 8 μg/L. Data from one of BC's two biomarker laboratories indicated that some residents of Vancouver and nearby suburbs have higher exposure to mercury than other BC residents. Of 127 individuals who had results in 2009 exceeding provisional guidance values, only 45% were tested again within 12 months.
Conclusion:
Collating and analyzing all clinical biomarker testing such as blood mercury at a provincial population level allows for assessment of the adequacy and appropriateness of follow-up testing and suggests which regional and demographic strata are at higher levels of exposure.
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