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International Journal of Health Geographics

, 13:30

First Online: 15 August 2014Received: 17 April 2014Accepted: 21 July 2014DOI: 10.1186-1476-072X-13-30

Cite this article as: Burch, J.B., Wagner Robb, S., Puett, R. et al. Int J Health Geogr 2014 13: 30. doi:10.1186-1476-072X-13-30


BackgroundMercury is a metal with widespread distribution in aquatic ecosystems and significant neurodevelopmental toxicity in humans. Fish biomonitoring for total mercury has been conducted in South Carolina SC since 1976, and consumption advisories have been posted for many SC waterways. However, there is limited information on the potential reproductive impacts of mercury due to recreational or subsistence fish consumption.

MethodsTo address this issue, geocoded residential locations for live births from the Vital Statistics Registry 1995–2005, N = 362,625 were linked with spatially interpolated total mercury concentrations in fish to estimate potential mercury exposure from consumption of locally caught fish. Generalized estimating equations were used to test the hypothesis that risk of low birth weight LBW, <2,500 grams or preterm birth PTB, <37 weeks clinical gestation was greater among women living in areas with elevated total mercury in fish, after adjustment for confounding. Separate analyses estimated term LBW and PTB risks using residential proximity to rivers with fish consumption advisories to characterize exposure.

ResultsTerm LBW was more likely among women residing in areas in the upper quartile of predicted total mercury in fish odds ratio OR = 1.04; 95% confidence interval CI: 1.00-1.09 or within 8 kilometers of a river with a ‘do not eat’ fish advisory 1.05; 1.00-1.11 compared to the lowest quartile, or rivers without fish consumption restrictions, respectively. When stratified by race, risks for term LBW or PTB were 10-18% more likely among African-American AA mothers living in areas with the highest total fish mercury concentrations.

ConclusionsTo our knowledge, this is the first study to examine the relationship between fish total mercury concentrations and adverse reproductive outcomes in a large population-based sample that included AA women. The ecologic nature of exposure assessment in this study precludes causal inference. However, the results suggest a need for more detailed investigations to characterize patterns of local fish consumption and potential dose–response relationships between mercury exposure and adverse reproductive outcomes, particularly among AA mothers.

KeywordsLow birth weight Environmental public health tracking Geographic information system Preterm birth AbbreviationsAAAfrican-American

CIConfidence interval


GEDGeneral education degree

GISGeographic information system

LBWLow birth weight

OROdds ratio

PTBPreterm birth

SCSouth Carolina

SC DHECSouth Carolina Department of Health and Environmental Control

USUnited States

USCUniversity of South Carolina.

Electronic supplementary materialThe online version of this article doi:10.1186-1476-072X-13-30 contains supplementary material, which is available to authorized users.

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Autor: James B Burch - Sara Wagner Robb - Robin Puett - Bo Cai - Rebecca Wilkerson - Wilfried Karmaus - John Vena - Erik Svendse


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