AMAP Assessment 2015: Human Health in the Arctic

178 Pages·2016·9.19 MB·English

AMAP Assessment 2015:
Human Health in the Arctic
Arctic Monitoring and Assessment Programme (AMAP)
Educational use: This report (in part or in its entirety) and other AMAP products available from www.amap.no can be used
freely as teaching materials and for other educational purposes.
The only condition of such use is acknowledgement of AMAP as the source of the material according to the recommended citation.
In case of questions regarding educational use, please contact the AMAP Secretariat ([email protected]).
Note: This report may contain material (e.g. photographs) for which permission for use will need to be obtained from
original copyright holders.
Disclaimer: The views expressed in this peer-reviewed report are the responsibility of the authors of the report and do not
necessarily reflect the views of the Arctic Council, its members or its observers.
AMAP Assessment 2015:
Human Health in the Arctic
Arctic Monitoring and Assessment Programme (AMAP)
Oslo, 2015
ii AMAP Assessment 2015: Human Health in the Arctic
AMAP Assessment 2015: Human Health in the Arctic
ISBN – 978-82-7971-093-6
© Arctic Monitoring and Assessment Programme, 2015
Citation
AMAP Assessment 2015: Human Health in the Arctic. Arctic Monitoring and Assessment Programme (AMAP),
Oslo, Norway. vii + 165 pp
Published by
Arctic Monitoring and Assessment Programme (AMAP), Oslo, Norway. (www.amap.no)
Ordering
This report can be ordered from the AMAP Secretariat, Gaustadalléen 21, N-0349 Oslo, Norway
This report is also published as electronic documents, available from the AMAP website at www.amap.no
Production
Production management
Simon Wilson and Janet Pawlak (AMAP Secretariat)
Scientific, technical and linguistic editing
Carolyn Symon ([email protected])
Lay-out and technical production
Burnthebook, United Kingdom (www.burnthebook.co.uk)
Design and production of computer graphics
Simon Duckworth ([email protected])
Cover photograph
As ice conditions change, indigenous whalers in Alaska are using modern boats during the spring hunt in combination with
traditional hunting methods. Photo: Michael Brubaker
Printing
Narayana Press, Gylling, DK-8300 Odder, Denmark (www.narayanapress.dk).
AMAP Working Group (during period of preparation of this assessment)
Morten Olsen (Chair, Denmark), Russel Shearer (Vice-Chair, Canada), Fred Wrona (Canada), Mikala Klint (Denmark), Outi
Mähönen (Vice-Chair, Finland), Helgi Jensson (Iceland), Per Døvle (Norway), Tove Lundberg (Sweden), Yuri Tsaturov (Vice-Chair,
Russia), Tom Armstrong (United States), Eva Krümmel (ICC)
AMAP Secretariat
Lars-Otto Reiersen, Simon Wilson, Jon Fuglestad, Jan-Rene Larsen, Janet Pawlak, Inger Utne
Arctic Council Member States and Permanent Participants of the Council
Canada, Denmark/Greenland/Faroe Islands, Finland, Iceland, Norway, Russia, Sweden, United States, Aleut International
Association (AIA), Arctic Athabaskan Council (AAC), Gwitch’in Council International (GCI), Inuit Circumpolar Council (ICC),
Russian Association of Indigenous Peoples of the North (RAIPON), Saami Council
iii
Acknowledgments
Authors (see chapters for details)
Shawn Donaldson (assessment co-lead), Jon Øyvind Odland (assessment co-lead), Bryan Adlard, Pierre Ayotte, Célyne Bastien,
Carolina Behe, Jake Bell, Ingvar Bergdahl, James Berner, Peter Bjerregaard, Eva Bonefeld-Jørgensen, Michael Brubaker, Anders
Carlsen, Fróði Debes, Éric Dewailly†, Alexey Dudarev, Parnuna Egede, Chris Furgal, Jennifer C. Gibson, Andrew Gilman, Philippe
Grandjean, Jónrit Halling, Solrunn Hansen, Joseph Jacobson, Sandra Jacobson, Eva-Maria Krümmel, Anne Regine Lager, Tara
Leech, Manhai Long, Stephanie Meakin, Gina Muckle, Gert Mulvad, Therese Nost, Kristín Olafsdottir, Alan Parkinson, Maria
Skaalum Petersen, Pierrich Plusquellec, Arja Rautio, Boris Revitch, Dave Saint-Amour, Torkjel M. Sandanger, Moses Tcheripanoff,
Anna Sofía Veyhe, Pál Weihe, Maria Wennberg
Bold: coordinating authors
Contributing authors and Contributors
Ingvar Bergdahl, Olivier Boucher, Louisa Castrodale, Laurie Hing Man Chan, Valery Chupakhin, Meredith S. Curren, Renee
Dallaire, Maria Dam, Rune Dietz, Audrey-Anne Ethier, Robert Gerlach, Britta Hedlund, Caroline Jacques, Nina Nielsen, Karen
Pletnikoff, Annie St-Amand, Ulrike Steuerwald, Gunnar Toft, Beatriz Valera
DEDICATION
from Quebec are still outstanding and then we could have a good (and long
and must be regarded as foundational lasting!) dinner. To enjoy life meant that
pioneer work. The combination of public his pipe was with him, and there was no
health and toxicology research was the fanatical talk about risk factors. Another
basis for the development of a great not well known side of Éric was his
network; in Canada, in all circumpolar talent as a story teller. Those of us who
countries, and, not least, across all the participated in the Svalbard meeting will
scientific disciplines needed for good remember hours of funny stories from
research in environmental medicine. His all the places in the world he visited, of
laboratory in Quebec and the generous course with his special French way of
contribution from Health Canada to the expressing himself.
first AMAP human health assessment
We lost some of our future with Éric.
made it possible to produce compatible
He was a mentor and a supervisor for
and reliable data from all circumpolar
the most brilliant scientists of the new
countries, for the first time in history.
generation. Even so, some of us are in the
Éric’s scientific portfolio speaks for itself. same generation and we will continue the
In memory of a great scientist He published a few hundred papers in work in the spirit of how we think Éric
and friend his decades-long career, always filled would have continued. We are certain
with new ideas and new questions; that he would agree with that. We will
The AMAP Human Health Assessment
otitis media, cardio-vascular effects, do the best we can, and hopefully he will
Report 2015 is dedicated to our esteemed
reproductive effects, and immune send his strong corrections from above if
colleague, Dr. Éric Dewailly. He died in
effects, just to mention a few. The 2015 we are not on the right track. Thank you
a tragic accident at La Réunion in June
report contains substantial results of his for everything, Éric!
2014, while on vacation together with
excellent work. We hope that his fear of
his family. Jon Øyvind Odland and Shawn
a ‘boring report’ has not been realized.
Donaldson (Co-chairs AMAP Human
Éric was a leading expert in the AMAP
Just as important as his scientific life Health Assessment Group)
Human Health Assessment Group. He
was his social contribution to a large
was very clear that we needed not only
group of colleagues with very different
to monitor levels of contaminants in
backgrounds and perspectives. We
humans, but also to study the human
could have very open and interesting
health effects arising from these
discussions in a friendly atmosphere,
contaminants. His early research papers
iv AMAP Assessment 2015: Human Health in the Arctic
Contents
AMAP Assessment 2015: Human Health in the Arctic
............................................. ii
Acknowledgments
................................................................................................ iii
Preface
................................................................................................................. vii
Introduction
1. ........................................................................................................ 1
1.1 A MAP 1998 human health assessment ................................................................................ 1
1.2 A MAP 2002 human health assessment ............................................................................... 1
1.3 A MAP 2009 human health assessment ............................................................................... 2
1.4 Challenges for the AMAP 2015 human health assessment ............................................................. 2
Overview of ongoing cohort and dietary studies in the Arctic
2. ................................ 5
2.1 Introduction .......................................................................................................... 5
2.2 Arctic cohort and dietary studies ..................................................................................... 5
2.2.1 The MISA study ................................................................................................... 5
2.2.2 The Tromsø study ................................................................................................. 6
2.2.3 Northern Finland 1966 Birth Cohort .................................................................................. 7
2.2.4 The Northern Sweden Health and Disease Study ....................................................................... 8
2.2.5 Chukotka dietary and exposure study ................................................................................. 9
2.2.6 Follow-up Chukotka coastal mother-child study 2001–2007: exposure and infection disease study ........................... 10
2.2.7 Chukotka birth cohort 2001–2003: exposure and reproductive effects .................................................... 11
2.2.8 Kola Lapland 2001–2006: POPs and diabetes mellitus ................................................................. 11
2.2.9 Nunavik Child Development Study .................................................................................. 12
2.2.10 Inuit Adult Cohorts: Canada ....................................................................................... 13
2.2.11 INUENDO ..................................................................................................... 13
2.2.12 CLEAR ......................................................................................................... 14
2.2.13 IVAAQ ......................................................................................................... 14
2.2.14 ACCEPT ....................................................................................................... 14
2.2.15 Follow-up of children from the IVAAQ and CLEAR cohorts in Greenland ................................................ 16
2.2.16 The Greenland Population Health Studies .......................................................................... 16
2.2.17 Birth Cohort 1 in the Faroe Islands ................................................................................. 17
2.2.18 Birth Cohort 2 in the Faroe Islands ................................................................................. 17
2.2.19 Birth Cohort 3 in the Faroe Islands ................................................................................. 18
2.2.20 Birth Cohort 5 in the Faroe Islands ................................................................................. 18
2.2.21 The septuagenarian cohort of the Faroe Islands ..................................................................... 19
2.2.22 Type 2 Diabetes in middle-aged Faroese residents ................................................................... 19
2.3 Conclusions and recommendations ................................................................................. 20
Levels and trends of contaminants in humans
3. ..................................................... 21
3.1 Introduction ......................................................................................................... 21
3.2 Synthesis ............................................................................................................ 21
3.2.1 AMAP 1998 ...................................................................................................... 21
3.2.2 AMAP 2002 ...................................................................................................... 21
3.2.3 AMAP 2009 ...................................................................................................... 22
3.2.4 AMAP 2015 ...................................................................................................... 22
3.3 Methodology for AMAP 2015 ........................................................................................ 22
3.4 National reports ..................................................................................................... 23
3.4.1 Alaska ........................................................................................................... 23
3.4.2 Canada .......................................................................................................... 25
3.4.3 Greenland ....................................................................................................... 31
3.4.4 Iceland .......................................................................................................... 38
3.4.5 Faroe Islands .................................................................................................... 39
3.4.6 Norway ......................................................................................................... 42
3.4.7 Sweden ......................................................................................................... 47
3.4.8 Finland .......................................................................................................... 53
3.4.9 Russia .......................................................................................................... 54
v
3.5 International comparisons ........................................................................................... 58
3.5.1 Persistent organic pollutants ....................................................................................... 58
3.5.2 Metals .......................................................................................................... 58
3.6 Tissue concentrations of contaminants and guidelines: case studies ................................................. 58
3.6.1 Exceedances in Canada ............................................................................................ 60
3.6.2 Exceedances in Greenland ......................................................................................... 60
3.7 Discussion .......................................................................................................... 62
3.8 Conclusions and recommendations .................................................................................. 63
3.8.1 Conclusions ..................................................................................................... 63
3.8.2 Recommendations ............................................................................................... 64
Chapter 3 Appendix ..................................................................................................... 65
Health effects associated with measured levels of contaminants in the Arctic
4. ....... 77
4.1 Introduction ......................................................................................................... 77
4.2 Neurobehavioral effects ............................................................................................. 77
4.2.1 Mercury ......................................................................................................... 77
4.2.2 Lead ............................................................................................................ 80
4.2.3 Persistent organic pollutants ....................................................................................... 80
4.3 Immunological effects............................................................................................... 81
4.4 Reproductive effects ................................................................................................ 81
4.5 Cardiovascular effects .............................................................................................. 83
4.5.1 Mercury ......................................................................................................... 83
4.6 Endocrine effects ................................................................................................... 83
4.6.1 Biomarkers of POPs exposure and their endocrine-disrupting effects .................................................... 83
4.6.2 C ombined effect of serum legacy POPs on hormone receptor transactivities ex vivo .......................................... 88
4.6.3 Persistent organic pollutants and Type 2 diabetes ..................................................................... 90
4.7 Carcinogenic effects ................................................................................................ 90
4.7.1 Contaminant exposure, oxidative stress and carcinogenicity ............................................................ 91
4.7.2 Contaminant exposure and cancer risk in Arctic regions ................................................................ 92
4.8 Genetic modifiers .................................................................................................. 94
4.8.1 Gene–Environment interactions in relation to cancer risk .............................................................. 94
4.8.2 Genetic polymorphisms and contaminants in the Arctic ............................................................... 94
4.8.3 Genetics in relation to lifestyle factors in Arctic populations ............................................................ 94
4.8.4 Genetic variability and hepatitis in the Arctic ......................................................................... 95
4.8.5 Genetics in relation to hearing impairment in the Arctic ............................................................... 95
4.8.6 Metabolism and contaminants: animal studies to mimic human exposures .............................................. 95
4.8.7 Epigenetics ...................................................................................................... 96
4.8.8 Genetic predisposition and methylmercury neurotoxicity ............................................................... 96
4.9 Effect modifiers .................................................................................................... 97
4.10 Conclusions ....................................................................................................... 97
Approaches to describe risks and future needs
5. .................................................... 99
5.1 Introduction ......................................................................................................... 99
5.2 Blood levels and biological guideline values for contaminants ........................................................ 99
5.3 Mercury levels in the Arctic and in Europe .......................................................................... 101
5.4 Health outcomes and mercury exposure ........................................................................... 101
5.5 Levels of organohalogens and PCBs ................................................................................ 101
5.6 Health outcomes and organohalogens ............................................................................. 102
5.7 Contaminants and placental transport ............................................................................. 102
5.8 Modelling .......................................................................................................... 103
5.8.1 Toxicokinetic modelling of PCB153 ................................................................................. 103
5.8.2 CoZMoMAN model .............................................................................................. 104
5.9 Literature review ................................................................................................... 104
5.9.1 Health outcomes – critical reviews ................................................................................. 104
5.9.2 Problems identified in meta-analyses ............................................................................... 105
5.10 Toxicokinetic modelling and future risk prediction ................................................................. 106
5.11 Toxicokinetic modelling and total risk estimation ................................................................... 107
5.12 The incorporation of in vitro mechanistic studies in human health risk assessment ................................. 107
5.13 Conclusions and recommendations ................................................................................ 109
vi AMAP Assessment 2015: Human Health in the Arctic
Risk communication
6. ......................................................................................... 111
6.1 Introduction ........................................................................................................ 111
6.2 Approaches to risk communication ................................................................................. 111
6.3 Evaluating the effectiveness of risk communication strategies ....................................................... 113
6.4 Arctic-specific experiences in risk communication .................................................................. 113
6.4.1 Alaska, US ..................................................................................................... 113
6.4.2 Canada......................................................................................................... 114
6.4.3 Faroe Islands: Dietary advice on consumption of pilot whale .......................................................... 116
6.4.4 Greenland: Addressing conflicting evidence about diet and health ..................................................... 116
6.4.5 Russia: POPs and metals in Chukotka ............................................................................. 118
6.4.6 Circumpolar Inuit perspectives .................................................................................... 118
6.5 International risk communication experiences related to the Arctic .................................................. 119
6.6 Application of social media for risk communication in the Arctic .................................................... 121
6.6.1 Social media for health risk communications: forms, practices and effectiveness ......................................... 121
6.6.2 Social media as a tool and opportunity for risk communication in the Arctic ............................................. 122
6.6.3 Considerations for social media use in Arctic risk communications ..................................................... 122
6.7 O ptimizing risk communication in the Arctic ........................................................................ 123
6.8 Conclusions, recommendations and knowledge gaps ............................................................... 124
6.8.1 Conclusions .................................................................................................... 124
6.8.2 Recommendations .............................................................................................. 124
6.8.3 Knowledge gaps ................................................................................................. 125
Adaptation in Arctic circumpolar communities:
7.
Food and water security in a changing climate
.................................................... 127
7.1 Introduction ........................................................................................................ 127
7.2 Categories of environmental threat ................................................................................. 127
7.2.1 Climate change in the Arctic region ................................................................................. 127
7.2.2 Anthropogenic contaminants...................................................................................... 128
7.2.3 Zoonotic diseases ............................................................................................... 128
7.2.4 Combined effects of climate warming, anthropogenic contaminants and zoonotic disease ................................. 128
7.3 Developing a community-based adaptation strategy ................................................................ 128
7.4 Managing the response to environmental threats ................................................................... 129
7.4.1 Seasonal changes to whale hunting in Wainwright, Alaska ............................................................. 129
7.4.2 Maintaining food security – an example from the Canadian Arctic ...................................................... 130
7.4.3 Applying local observation in response to food safety concerns ........................................................ 130
7.5 ArcRisk – key findings for community adaptation.................................................................... 131
7.6 Conclusions and recommendations for addressing gaps in knowledge ............................................... 132
Key findings and recommendations
8. ................................................................... 135
8.1 Key findings from the 2015 human health assessment ............................................................... 135
8.1.1 Biomonitoring ................................................................................................... 135
8.1.2 Health effects ................................................................................................... 136
8.1.3 Risk description ................................................................................................. 137
8.1.4 Risk communication ............................................................................................. 137
8.1.5 Climate change adaptation ........................................................................................ 137
8.2 Knowledge gaps .................................................................................................... 138
8.2.1 Biomonitoring .................................................................................................. 138
8.2.2 Health effects ................................................................................................... 138
8.2.3 Risk description ................................................................................................. 138
8.2.4 Risk communication ............................................................................................. 138
8.2.5 Climate change adaptation ....................................................................................... 138
8.3 Key recommendations .............................................................................................. 139
References
.......................................................................................................... 141
Acronyms and Abbreviations
................................................................................ 165
vii
Preface
This assessment report presents the results of the 2015 AMAP Related assessment summary reportsi,ii have therefore been
Assessment of Human Health in the Arctic. This is the fourth developed specifically for policy-makers, summarizing the
AMAP assessment dealing with this issue in a sequence and main findings of the assessment. The assessment lead authors
updates the assessments delivered in 1998, 2002 and 2009. have confirmed that both this report and its derivative products
accurately and fully reflect their scientific assessment. All
The Arctic Monitoring and Assessment Programme (AMAP) is
AMAP assessment reports are freely available from the AMAP
a group working under the Arctic Council. The Arctic Council
Secretariat and on the AMAP website: www.amap.no, and their
Ministers have requested AMAP to:
use for educational purposes is encouraged.
• produce integrated assessment reports on the status and
AMAP would like to express its appreciation to all experts who
trends of the conditions of the Arctic ecosystems
have contributed their time, efforts and data, in particular the lead
• identify possible causes for the changing conditions authors who coordinated the production of this report. Thanks
are also due to the reviewers who contributed to the human
• detect emerging problems, their possible causes, and the
health assessment peer-review process and provided valuable
potential risk to Arctic ecosystems including indigenous
comments that helped to ensure the quality of the report. A
peoples and other Arctic residents
list of contributors is included in the acknowledgements at the
• recommend actions required to reduce risks to Arctic start of this report and lead authors are identified at the start of
ecosystems. each chapter. The acknowledgements list is not comprehensive.
Specifically, it does not include the many national institutes,
This report provides the accessible scientific basis and validation
laboratories and organizations, and their staff, which have
for the statements and recommendations made in the Summary
been involved in various countries in human health-related
for Policy-makers: Arctic Pollution Issues 2015 reporti that was
monitoring and research. Apologies, and no lesser thanks are
delivered to Arctic Council Ministers at their meeting in Iqaluit,
given to any individuals unintentionally omitted from the list.
Canada in April 2015. It is also the basis for a related AMAP
State of the Arctic Environment report Arctic Pollution Issues The support from the Arctic countries and non-Arctic countries
2015: Overviewii. It includes extensive background data and implementing research and monitoring in the Arctic is vital to
references to the scientific literature, and details the sources the success of AMAP. The AMAP work is essentially based on
for graphics reproduced in the overview report. Whereas the ongoing activities within these countries, and the countries
Summary for Policy-makers report contains recommendations that provide the necessary support for most of the experts
that focus mainly on policy-relevant actions concerned with involved in the preparation of the AMAP assessments. In
addressing contaminant impacts on Arctic human populations, particular, AMAP would like to acknowledge Canada and
the conclusions and recommendations presented in this report Norway for taking the lead country role in this assessment
also cover issues of a more scientific nature, such as proposals and thank Canada, Denmark, Norway, and the Nordic Council
for filling gaps in knowledge, and recommendations relevant of Ministers for their financial support to the human health
to future monitoring and research work. assessment work. The contribution of the Inuit Circumpolar
Council (ICC) to the preparation of this assessment is also
This assessment of Arctic human health impacts of contaminants
greatly appreciated.
and other stressors was conducted between 2012 and 2014 by an
international group of over 60 experts. AMAP Human Health The AMAP Working Group is pleased to present its assessment
assessment group members and lead authors are appointed to the Arctic Council and the international science community.
following an open nomination process coordinated by AMAP.
Shawn Donaldson (Human health assessment Co-lead, Canada)
A similar process was used to select international experts who
independently reviewed this report. Jon Øyvind Odland (Human health assessment Co-lead, Norway)
Information contained in this report is fully referenced and Morten Olsen (AMAP Chair, April 2015)
based first and foremost on peer-reviewed and published
Lars-Otto Reiersen (AMAP Executive Secretary)
results of research and monitoring undertaken since 2009.
It also incorporates some new (unpublished) information Oslo, December 2015
from monitoring and research conducted according to well-
established and documented national and international
standards and quality assurance/quality control protocols. Care
has been taken to ensure that no critical probability statements
are based on non-peer-reviewed materials.
Access to reliable and up-to-date information is essential for
the development of science-based decision-making regarding
ongoing changes in the Arctic and their global implications.
i AMAP, 2015. Summary for Policy-makers: Arctic Pollution Issues 2015. Arctic Monitoring and Assessment Programme (AMAP), Oslo, Norway. 12 pp.
ii AMAP, 2015. Pollution Issues 2015: Overview report. Arctic Monitoring and Assessment Programme (AMAP), Oslo, Norway.
viii AMAP Assessment 2015: Human Health in the Arctic