PDS 62: Chemicals and metals: exposure and biomarkers, Johan Friso Foyer, Floor 1, August 28, 2019, 10:30 AM - 12:00 PM Background: Arsenic, cadmium, lead, and mercury are among the World Health Organization’s top ten chemicals of public health concern. Exposure to these toxic trace elements (TTE) presents a potential health threat to populations in regions undergoing rapid environmental change. The Andean-Amazon region of Madre de Dios (MDD), Peru, is among the most biologically diverse places in the world; access to this area has been opened with the paving of the Interoceanic Highway (IOH), which bisects the region. Deforestation, artisanal and small-scale gold mining, and rapid development increase TTE exposure opportunities. Methods: As part of the population-based Investigacion de Migracion, Ambiente, y Salud (IMAS) (Migration, Environment, and Health Study), we conducted an analysis of exposure to arsenic, cadmium, lead, and mercury in nails among adults (18+ years) living along the IOH throughout MDD (n=418) in 2014. We tested for differences by selected individual and household characteristics and local land uses using one-way ANOVAs and generalized estimating equations. Results: TTE medians and ranges (ng/g) were: total mercury: 512 (18 – 5,600); total arsenic: 177 (8 – 1,260); total cadmium: 62 (1 – 3,710); total lead: 734 (112 – 572,000). Mining activities were associated with higher arsenic, cadmium, and mercury levels. Fishing was associated with higher arsenic, mercury, and lead concentrations, while household fish consumption was associated with higher concentrations of mercury and lower concentrations of cadmium. Current smoking was not associated with cadmium. High outliers for lead were observed. Conclusions: TTE exposure was heterogenous across the region and overall, was higher than what has been observed in population-based studies elsewhere. Exposures correlated to mining and fishing activities merit further investigation. While nails are easy to collect and transport, especially in remote regions of low and middle-income countries like MDD, other counterintuitive results suggest that nails may be problematic biomarkers for these elements.