Biologic indicators of exposure to heavy metals in fish consumers : technical assistance to the American Samoa government, Department of Health Services, Pago Pago, American Samoa

176 Pages·1995·7.6 MB·English

PB95-182994
Agency for Toxic
Substances and
Disease Registry
Division of Health Studies
FINAL REPORT
Technical Assistance to the
American Samoa Government
Department of Health Services
Pago Pago, American Samoa
Biologic Indicators of Exposure to
Heavy Metals in Fish Consumers, American Samoa
March 1995
o^‘
i U.S. DEPARTMENT OF HEALTH
; & HUMAN SERVICES
A|j. I Public Health Service
£
H

ot ; Agency for Toxic Substances
and Disease Registry
Atlanta, Georgia 30333
AK ^IDSF
In 1980, Congress created the Agency for Toxic Substances and Disease Registry (ATSDR) to implement
health-related sections of laws that protect the public from hazardous wastes and environmental spills of
hazardous substances. The Comprehensive Environmental Response, Compensation, and Liability Act of 1980
(CERCLA), commonly known as the "Superfund" Act, designated ATSDR as the lead agency within the U.S. Public
Health Service to help prevent or reduce further exposure to hazardous substances and the adverse health effects
that result from such exposures, and also to expand the knowledge base about such effects.
This publication reports the results and findings of a health study, registry, or other health-related activity
supported by ATSDR in accordance with its legislative mandate described above.
Comments regarding this report are welcome. Please address to:
Agency for Toxic Substances and Disease Registry
Attn: Director, Division of Health Studies (E-31)
1600 Clifton Road, N.E.
Atlanta, Georgia 30333
Agency for Toxic Substances
and Disease Registry . David Satcher, MD, PhD, Administrator
Barry L. Johnson, PhD, Assistant Administrator
John S. Andrews, Jr., MD, MPH, Associate Administrator for Science
Division of Health Studies . Jeffrey A. Lybarger, MD, MS, Director
Sharon S. Campolucci, MSN, Deputy Director
Robert F. Spengler, ScD, Assistant Director for Science
Connie L. Whitehead, Editor
Health Investigations Branch . Michael A. McGeehin, PhD, MSPH, Chief
Rosaline J. Dhara, MPH
Sheena M. Dixon
Machel M. Forney
Suzanne G. Folger, MPH
G. Brent Hamar, DDS, MPH
Paul A. Jones, MS
Martha S. Miller, MPH
Betty L. Phifer, MS
Ravishankar A. Rao, MPH, MPA
Sara Moir Sarasua, MSPH
Gina J. Terracciano, DO, MPH
Priscilla L. Young, MD
Helena Y. Zabina, MD
Epidemiology and Surveillance Branch . . Wendy E. Kaye, MHS, PhD, Chief
Exposure and Disease Registry Branch JeAnne R. Burg, PhD, MS, MA, Chief
Additional copies of this report are available from:
National Technical Information Service, Springfield, Virginia
[phone]
Request publication number PB95-182994
OAKSTHDSP
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
PUBLIC HEALTH SERVICE
AGENCY FOR TOXIC SUBSTANCES AND DISEASE REGISTRY
ATLANTA, GEORGIA
BIOLOGIC INDICATORS OF EXPOSURE TO HEAVY METALS
IN FISH CONSUMERS
TECHNICAL ASSISTANCE TO THE
AMERICAN SAMOA GOVERNMENT, DEPARTMENT OF HEALTH SERVICES
PAGO PAGO, AMERICAN SAMOA
March 1995
This report was supported in part by funds from the Comprehensive
Environmental Response, Compensation, and Liability Act (CELRCLA) trust fund
through technical ^sistance with the Agency for Toxic Substances and Disease
Registry, Public Health Service, U,S. Department of Health and Human Services.
DISCLAIMER
Mention of the name of any company or product does not constitute endorsement by the Agency
for Toxic Substances and Disease Registry, the Public Health Service, or the U.S. Department
of Health and Human Services.
u
CONTENTS
Page
DISCLAIMER. u
UST OF TABLES . v
UST OF APPENDICES. vii
ABSTRACT . 1
INTRODUCTION. 3
OBJECTIVES . 3
BACKGROUND. 4
Presence of Heavy Metals in the Environment. 4
Pathways of Exposure and Confounders in Humans. 4
Site Characterization. 7
METHODS. 8
Rationale for Study Design. 8
Community Involvement and Notification. 8
Selection of Target Area . 9
Selection of Comparison Area. 9
Participant Selection. 9
Sample Size Calculations.10
Sampling Algorithm.10
Data Collection.10
Biologic Specimens.12
Privacy.13
Data Entry.13
Data Analysis.14
RESULTS.16
Participation .17
Demographic and Other Characteristics .17
Analyte Results.18
Modeling Results.23
DISCUSSION .24
CONCLUSIONS.29
m
RECOMMENDATIONS.31
AUTHORS AND ACKNOWLEDGEMENTS.33
REFERENCES .35
TABLES .39
APPENDICES .87
iv
LIST OF TABLES
Page
Table 1.—Participation rates for target and comparison groups.41
Table 2.—Comparison of participants selected and interviewed
by village between the target and comparison communities.43
Table 3.—Demographic and other characteristics of target and
comparison communities .45
Table 4.—Distribution of how often participants ate fish each week in the
month prior to the survey for target and comparison groups .47
Table 5.—Comparison of low versus high levels of fish consumption,
by village between target and comparison communities.49
Table 6A.—Urine analyte results, target and comparison groups.51
Table 6B.—Blood analyte results, target and comparison groups.53
Table 7.—Statistically significant urine analytes, three age groups,
target and comparison groups .55
Table 8A.—Urine and blood analyte results by level of fish consumption,
for participants 8 through 25 years of age.57
Table 8B.—Urine and blood analyte results by level of fish consumption,
for participants 26 through 45 years of age.59
Table 8C.—Urine and blood analyte results by level of fish consumption,
for participants 46 through 75 years of age.61
Table 9.—Urine arsenic results among participants who ate fish
versus those who did not eat fish within 48 hours of urine collection .63
Table 10.—Comparison of geometric mean urine arsenic levels for statistically
significant variables.65
Table 11.—Odds ratios and 95% confidence intervals with
elevated urine arsenic levels . 67
Table 12.—Comparison of geometric mean urine cadmium levels
for statistically significant variables.69
V
Table 13.—Comparison of geometric mean urine mercury levels for statistically
significant variables.71
Table 14.—Comparison of geometric mean urine nickel levels for statistically
significant variables.73
Table 15.—Comparison of geometric mean blood mercury levels for statistically
significant variables, three age groups.75
Table 16.—Odds ratios and 95% confidence intervals with elevated
blood mercury levels, three age groups .77
Table 17A.—Linear regression model for urine arsenic in
8- to 75-year olds.79
Table 17B.—Logistic regression model for urine arsenic among
8- to 75-year olds.79
Table 18A.—Linear regression model for blood mercury in 8- to 75-year olds.81
Table 18B.—Logistic regression model for blood mercury among
8- to 75-year olds.81
Table 19.—Linear regression model for urine cadmium in 8- to 75-year olds.83
Table 20.—Blood and urine analyte levels, inner versus outer harbor
participants who ate fish caught in Pago Pago Harbor one month before
the survey.85
I
VI
LIST OF APPENDICES
Appendix A—Maps of American Samoa .A-1
' Appendix B—Pago Pago Harbor Health Advisory .B-1
Appendix C—Request for Technical Assistance.. C-1
Appendix D—Food and Drug Administration
Suggested Trace Metal Action Levels for Seafood.D-1
Appendix E—A Preliminary Toxicity of Fish Tissues AECOS, 1992 . E-1
Appendix F—Power and Sample Size Calculations, Colorado and Utah . F-1
Appendix G—Participant Consent for Interview,
Blood and Urine CoUetion.G-1
Appendix H—American Samoa Survey Questionnaire.H-1
Appendix I—A Comparison of Shoreline Catches by Species,
ASDMWR, 1991.M
Appendix J—Specimen Collection and Shipping Protocol.J-1
vii
Digitized by the Internet Archive
in 2019 with funding from
University of Illinois Urbana-Champaign Alternates
https://archive.org/detaffs/biologicindicatoOOunse