Abstract
BACKGROUND AND AIM: Mercury is a substance of high concern globally. It is biotransformed to methylmercury (MeHg), a potent developmental neurotoxicant bioaccumulating in aquatic food chains. Fish consumption during pregnancy can expose the fetus to mercury, but at the same time provides essential nutrients for optimal brain and eye development. The benefits can outweigh the risks if suitable dietary advice is followed. The harmonized European intervention study ‘HBM4EU-MOM’ combined fish consumption advice to pregnant women with human biomonitoring (HBM), to assess and control prenatal exposures to methylmercury. METHODS: Harmonized tools for HBM and communication of dietary advice were developed and applied in five countries (Cyprus, Greece, Portugal, Spain, Iceland). 654 women, recruited during early pregnancy in 2021, provided hair samples for mercury biomonitoring and extensive information about their fish consumption practices and preferences. Targeted fish consumption advice was communicated to randomized 'intervention participants' of each national cohort and exposures were reassessed after ≥12 weeks. RESULTS: At baseline, the cumulative geometric mean exposure (GM) was 0.59 μg/g, varied across countries from 1.56 μg/g to 0.31 μg/g and correlated with fish-consumption patterns. Around 12% of participants exceeded EFSA’s health-based guidance value (HB-GV = 1.8 μg/g). At reassessment, the mean exposures in the highest exposed countries decreased significantly and the overall number of participants exceeding EFSA’s HB-GV dropped to 7.5%. CONCLUSIONS: European pregnant women may exceed current health-based guidance values for mercury exposure because of inappropriate fish consumption, which can be maintained below HB-GV through suitable consumption. HBM provides a way to evaluate the effectiveness of fish-consumption advice. Harmonized European mercury biomonitoring informs policies to protect human health in vulnerable populations. HBM4EU-MOM was funded by the European Union’s Horizon 2020 research and innovation programme (Grant No.733032). KEYWORDS: mercury, hair, fish, exposure assessment, human biomonitoring, nutrition, pregnancy, dietary advice
Published Version
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