1. MERCURY IN NEWBORNS AND WOMEN OF CHILDBEARING AGE IN THE LAKE SUPERIOR BASIN September 25, 2013 Pat McCann Minnesota Department of Health

2. WI and MN Statewide Guidelines Mercury is main human health concern walleye > 20”, northern > 30”

3. Mercury Levels in Blood from Newborns in the Lake Superior Basin: Goals Determine range of mercury concentrations in newborns from Lake Superior Basin Assess feasibility of a novel method to analyze mercury in residual dried blood spots from Newborn Screening Lake Superior Binational Program, Chemical Committee Are there exposures of concern in the Superior Basin? Method to track temporal trends? Funded by U.S. EPA GLNPO 3

4. Design Total mercury measured in residual dried bloodspots from newborns whose mothers were from in the US portion of the Lake Superior Basin Births Nov 2008 through May 2010 1466 participants (MN =1126, WI =140, MI =200) MN informed consent Anonymized design, kept data on: sex of baby month of birth state of mother’s residence urban vs. non-urban residence (MN only)

5. Mercury in Residual Newborn Blood Spots, MN data (µg/l) N= 1126 Wide distribution Median = 0.83 µg/l 44% below MDL of 0.7 µg/l, most exposures low 10% above 5.8 µg/l (equivalent to RfD) 1% above 58 µg/l (equivalent to BMDL) Maximum concentration = 211 µg/l

6. Results No association between mercury concentration and sex or urban versus non-urban residence (MN). MN results suggest a seasonal exposure pattern Highest concentrations in summer months Mercury levels in infants from MN > WI ~MI Minnesotans have reported eating more locally-caught fish Minnesotans may be eating more higher mercury species (walleye and northern pike) Star Tribune, Feb 19 2013

7. Median Hg vs. Month of Birth (ND=0.7µg/l)

8. Conclusions This study provides evidence of mercury exposures in some pregnant women that need to be reduced 10% of MN babies tested were above EPA RfD for methylmercury Results provide fish advisory programs stronger evidence of need to communicate with women of childbearing age about reducing mercury exposure. Increased public health action is needed to ensure the public has information that promotes eating fish that are low in mercury.

9. Reducing Mercury Exposure in Women of Childbearing Age Goal: Health care providers integrate fish consumption advice into clinical practice Partners: Sawtooth Mountain Clinic, Northshore Cook Co. Hospital, Grand Portage Trust Lands, Grand Portage Health Service Design In-clinic screening questions for high Hg exposure from fish consumption Use biomonitoring for Hg and fatty acids (500 women) to validate Educational intervention to promote consumption of low Hg fish Timeline: October 2012 to September 2016

10. Acknowledgments MN Department of Health Newborn Screening Program Public Health Laboratory Environmental Health Tracking and Biomonitoring Program Environmental Health Division MI and WI Newborn Screening Programs WI Department of Human Services - Henry Anderson Advice on results interpretation - Philippe Grandjean, Alan Stern, Michael Gochfeld Funding provided by U.S. EPA GLNPO For more information: http://www.health.state.mn.us/fish http://www.health.state.mn.us/fish Or contact Patricia McCann: patricia.mccann@state.mn.us patricia.mccann@state.mn.us