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Mercury, dental amalgam fillings and intellectual abilities in Inuit school children in Greenland.

The hair mercury concentration of 125 Greenland pupils aged 12 to 17 was recorded and compared with the pupils' marks in selected school subjects. Mercury values ranged from 0.2 to 15.9 microgram per gram (micrograms/g) and 20% of the pupils had more than 6 micrograms/g. There was no correlation between a high mercury concentration score and poor results in school. Correlation of the number of dental amalgam fillings with mercury concentration showed a weak trend but no significant relation. Eating habits were significantly correlated with mercury concentration. Girls had a significantly higher number of amalgam fillings than boys, and had a significantly higher mercury concentration. Modern Inuit and the mummified Qilaqitsoq Inuit from the 15th century had largely identical levels of mercury in the hair irrespective of today's higher exposure to global environmental contamination. This is believed to result from a change in eating habits away from the traditional Greenland food towards a more continental diet.

Adolescent↗

Investigation and management of cervical intraepithelial neoplasia in Canadian Inuit: enhancing access to care.

Cervical intraepithelial neoplasia (CIN) is a major cause of morbidity among Circumpolar women. Cervical cancer comprised 15% of all cancers in Canadian Inuit women from 1969-1988. The age standardized incidence for invasive cervical cancer in Canadian Inuit women is 3.1 times the rate in the general Canadian population. Management of CIN in women of remote Arctic regions has traditionally required multiple visits to specialized medical centres for diagnosis, therapy and follow-up. Such centralized care requires separation of women from their families, resulting in significant medical, emotional and economic costs for the patient, her family and community. In the Canadian Central Arctic, a program for the diagnosis and therapy of CIN has been established using colposcopy with loop electrosurgery, performed by a trained local family practitioner and visiting gynecologist. Early program evaluation has indicated reduction in medical expenditures due to travel costs, minimal procedure-related morbidity and discomfort, and improved patient satisfaction associated with reduced separation from family and community. It is hoped that the program design, which harnesses technology in order to provide improved care closer to home, will be applicable to other Circumpolar regions.

Arctic Regions↗

[Research approaches in the meaning of suicide among teenage Inuit].

Is it possible to approach the suicide of teenage Inuit in the same way as in other communities, especially when taking into account the fact that suicide in Inuit is part of their traditions? The issue raised by the author essentially concerns the interpretation of data. This article offers new approaches to researching the meaning of suicide through a cultural viewpoint of the phenomenon and by taking into consideration the socio-political context. The author presents a new vision of suicide as an all-encompassing social fact that opens the door to more relevant interventions.

Adolescent↗

JC virus strains indigenous to northeastern Siberians and Canadian Inuits are unique but evolutionally related to those distributed throughout Europe and Mediterranean areas.

Human polyomavirus JC virus (JCV) isolates around the world are classified into more than 10 geographically distinct genotypes (designated as subtypes). Evolutionary relationships among JCV subtypes were recently examined, and the following pattern of JCV evolution was indicated. The ancestral JCV first divided into three superclusters, designated Types A, B, and C. A split in Type A generated two subtypes, EU-a and -b, containing mainly European and Mediterranean isolates. The split in Type B generated Af 2 (the major African subtype), Bl-c (a minor European subtype), and various Asian subtypes. Type C generated a single subtype (Afl), consisting of isolates derived from western Africa. In this study, JCV isolates prevalent among northeastern Siberians and Canadian Inuits were evaluated in the context of the above-described pattern of JCV evolution. The Siberian/Arctic JCV isolates were classified as belonging mainly to Type A, based on the result of a preliminary phylogenetic analysis. We then examined, using the whole-genome approach, the phylogenetic relationships among worldwide Type A isolates. In neighbor-joining and maximum-likelihood analyses, Type A JCVs worldwide consistently diverged into three subtypes, EU-a, -b, and -c, with high bootstrap probabilities. EU-c was constructed only by northeastern Siberian isolates, derived mainly from Nanais living in the lower Amur River region, and was shown to have been generated by the first split in Type A. Most Siberian/Arctic isolates derived from Chukchis, Koryaks, and Canadian Inuits formed a distinct cluster within the EU-a subtype, with a high bootstrap probability. Based on the present findings, we discuss ancient human migrations, accompanied by Type A JCVs, across Asia and to Arctic areas of North America.

Adult↗

Correlates of health-care use: Inuit and Cree of northern Quebec.

This case study of the use of health-care services in northern Quebec is the first of a series of reports dealing with the health status, risk factors and access to care of the two major aboriginal populations in this region, the Cree and the Inuit. The focus of the broader study is on the health status and risk factors in these native populations. This research, based on a survey conducted in 1983-84, describes the present health status and health-care system of the Cree and Inuit, then presents a path analysis model of their use of health services. The purpose of this approach is to provide health planners and care providers with useful information and to encourage the development of well-organized and reasonable health-care service delivery to these populations.

Age Factors↗

Measles antibody seroprevalence rates among immunized Inuit, Innu and Caucasian subjects.

Measles antibody seroprevalence was compared in Innu, Inuit, and Caucasian peoples of northern Newfoundland, Canada, who were immunized with a single dose of M-M-R-II (Merck Research Laboratories) vaccine. Healthy, volunteer schoolchildren (n = 606) were enrolled. Measles antibody was measured with a whole virus measles-specific IgG EIA. Native (Innu and Inuit) schoolchildren (n = 253) had a significantly higher seropositive rate (83%) after a single dose of measles vaccine compared to Caucasian (n = 353) children (76%; p = 0.025), and higher mean antibody levels after immunization compared to Caucasian children (1.74 EIA units, vs. 1.63; p = 0.06). Caucasian children were more likely to have been immunized after age 15 months (20.6% vs. 9.6%; p = 0.001). There was no significant difference in the mean time interval between immunization and blood sampling for natives versus Caucasian (8.0 years vs. 7.95 years; p = 0.49). After adjustment for time from immunization and age at immunization, there remained a marginally significant racial difference in seropositivity (OR = 1.65, 95% CI 0.96, 2.83, p = 0.068). The unadjusted odds ratio for seropositivity (comparing natives vs. non-natives, combining negative and equivocal results) was 1.66 (95% CI 1.06-2.59, p = 0.018). The higher measles-seropositive rate found among native compared to non-native Canadian children suggests that genetic and/or environmental factor(s) affect circulating antibody levels following immunization. The determination of these sources of variability may lead to the development of more efficacious vaccines or delivery strategies.

Adolescent↗

The effects on plasma, red cell and platelet fatty acids of taking 12 g/day of ethyl-eicosapentaenoate for 16 months: dihomogammalinolenic, arachidonic and docosahexaenoic acids and relevance to Inuit metabolism.

A patient with mantle cell lymphoma took 12g/day of ethyl-eicosapentaenoate for 16 months. Compared to reference values, eicosapentaenoic and docosapentaenoic acids were elevated in plasma, red cells and platelets but docosahexaenoic acid levels were in the normal range. Arachidonic acid levels were moderately reduced but dihomogammalinolenic acid levels remained in the normal range. In spite of a long chain n-3 fatty acid intake higher than in most Inuit populations, arachidonic acid levels remained considerably higher in this patient than in the Inuit. The implications for understanding of fatty acid metabolism in humans are discussed.

8,11,14-Eicosatrienoic Acid↗

G-protein beta3 subunit gene splice variant and body fat distribution in Nunavut Inuit.

The GNB3 825T allele encodes a product that has enhanced activation of heterotrimeric G proteins in vitro and could play a role in adipogenesis. We therefore evaluated the possibility that the GNB3 825T allele was associated with obesity in a sample of 213 healthy Canadian Inuit. We found that body weight, body mass index, waist girth, hip girth, subscapular skinfold thickness, and triceps skinfold thickness were significantly higher in subjects with the GNB3 825T/T genotype than in subjects with other genotypes. Furthermore, two anthropometric ratios, namely that of waist to hip circumference and that of subscapular to triceps skinfold thickness, were not significantly different across genotypes. This suggested that the increased deposition of fat in subjects with the GNB3 825T/T genotype was generalized and not localized to particular subregions. There was no association of this genetic variation with blood pressure. The GNB3 825T/T genotype accounted for between 1.6% and 3.3% of the total variation (< or =13% of attributable variation) of the obesity-related traits. The potential for a genetic marker of obesity creates opportunities for future studies in the Inuit, not just to confirm the associations, but also to examine prospectively the influence of interventions and possible relationships between GNB3 825T and longer term complications of obesity.

Adolescent↗

Prenatal exposure of the northern Québec Inuit infants to environmental contaminants.

The Inuit population residing in Nunavik (northern Québec, Canada) relies on species from the marine food web for subsistence and is therefore exposed to high doses of environmental contaminants such as polychlorinated biphenyls and methylmercury and to a lesser extent lead. In view of the neurotoxic properties of these substances following developmental exposure, we initiated a study on infant development in this remote coastal population. Here we report the magnitude of prenatal exposure to these contaminants and to selective nutrients in Inuit mothers and their newborns who were recruited on the Hudson Bay coast. We conducted interviews during the women's pregnancies and at 1 and 11 months postpartum and collected biological samples for mercury, lead, polychlorinated biphenyls (PCBs), and chlorinated pesticides analyses as well as selenium and N-3 polyunsaturated fatty acids (n3-PUFA). Cord blood, maternal blood, and maternal hair mercury concentrations averaged 18.5 microg/L, 10.4 microg/L, and 3.7 microg/g, respectively, and are similar to those found in the Faroe Islands but lower than those documented in the Seychelles Islands and New Zealand cohorts. Concentrations of PCB congener 153 averaged 86.9, 105.3, and 131.6 microg/kg (lipids) in cord plasma, maternal plasma, and maternal milk, respectively; prenatal exposure to PCBs in the Nunavik cohort is similar to that reported in the Dutch but much lower than those in other Arctic cohorts. Levels of n3-PUFA in plasma phospholipids and selenium in blood are relatively high. The relatively low correlations observed between organochlorine and methylmercury concentrations may make it easier to identify the specific developmental deficits attributable to each toxicant. Similarly, the weak correlations noted between environmental contaminants and nutrients will facilitate the documentation of possible protective effects afforded by either n3-PUFA or selenium against neurotoxic contaminants.

Adult↗

Determinants of polychlorinated biphenyls and methylmercury exposure in inuit women of childbearing age.

The objectives of this study were to to identify maternal characteristics associated with traditional food consumption and to examine food items associated with polychlorinated biphenyls (PCBs) and mercury body burden in pregnant Inuit women from Northern Québec. We interviewed women from three communities at mid-pregnancy and at 1 and 11 months postpartum. We measured PCBs, Hg, and selenium in maternal blood; Hg was also measured in maternal hair. The women reported eating significant amounts of fish, beluga muktuk/fat, seal meat, and seal fat. Although consumption of fish and seal was associated with lower socioeconomic status, consumption of beluga whale was uniform across strata. Fish and seal meat consumption was associated with increased Hg concentrations in hair. Traditional food intake during pregnancy was unrelated to PCB body burden, which is more a function of lifetime consumption. This study corroborated previous findings relating marine mammal and fish consumption to increased Hg and selenium body burden. Despite widespread knowledge regarding the presence of these contaminants in traditional foods, a large proportion of Inuit women increased their consumption of these foods during pregnancy, primarily because of pregnancy-related changes in food preferences and the belief that these foods are beneficial during pregnancy.

Adipose Tissue↗

Breast cancer in Circumpolar Inuit 1969-1988.

Breast cancer was studied over a 20-year period in Inuit populations in the Circumpolar region. A total of 193 breast cancers were observed in women. The incidence increased from 28.2 per 100 000 in 1969-1973 to 34.3 per 100 000 in 1984-1988. However, the incidence is low, about half what could be expected based on the rates in Denmark, Canada and Connecticut (USA). The low incidence could be explained by the Inuit diet and other lifestyle factors. These benefits should be preserved, in particular in the young, to maintain a low breast cancer incidence.

Adolescent↗

Hepatitis virus infection in an isolated Canadian Inuit (Eskimo) population.

The epidemiology of Hepatitis A virus (HAV) and hepatitis B virus (HBV) infection was studied in a northern Canadian Inuit (Eskimo) settlement. Sera from 720 of the 850 inhabitants of Baker Lake, Canada, were tested for markers of HAV and HBV infection. Anti-HAV was present in 71% of the residents and its prevalence increased with age. Serologic evidence of HBV infections was found in 27% of residents. The prevalence increased with age, being uncommon under the age of 20 (6%) and almost universal over the age of 60 (93%). Among the 29 hepatitis B surface antigen (HBsAg) carriers identified, all were adults, all had low levels of HBsAg, and all were negative for hepatitis B e antigen (HBeAg) and DNA polymerase but positive for antibody to HBeAg. These data demonstrate a high prevalence of HAV and HBV infection in this population. Further, they suggest that a dramatic decrease in the transmission of HBV infection has occurred over the past 20-30 years.

Adolescent↗

Physiological consequences of acculturation: a 20-year study of fitness in an Inuit community.

Surveys in 1969/1970, 1979/1980, and 1989/1990 assessed physical fitness among adult Inuit living in Igloolik, Northwest Territories, Canada, during a period of rapid acculturation to a sedentary lifestyle. MANOVA for age, cohort, and age-cohort effects indicated significant trends to greater skinfold readings [male (M) and female (F)] and body mass (F only), a lower handgrip and knee extension force (M and F), and lower step test predictions of aerobic power (M and F) in the more recent cohorts, with no change of forced vital capacity, 1-s forced expiratory volume, or hemoglobin level. By 1989/1990, continuing hunters tended to have thicker skinfolds than other villagers, and showed no advantage of aerobic power. The average fitness of the sample when tested in 1989/1990 was comparable with that of sedentary populations in Southern Canada, but a minority of villagers who now practiced regular sport had conserved the high levels of fitness that were observed in 1969/1970. We conclude that the fitness of this community appears to have deteriorated markedly as it has become more sedentary, and we thus recommend that health authorities develop methods of promoting an active lifestyle that are culturally appropriate to the populations of circumpolar settlements.

Acculturation↗

Blood and urinary cadmium levels in Inuit living in Kuujjuaq, Canada.

Blood and urine cadmium concentrations have been determined in a group of 85 Inuit residents of Kuujjuaq, Quebec, Canada, drawn from actively hunting households. Mean blood cadmium values are high at 39.4 nmol/l, varying between 6.6 in non-smokers and 60.3 in smokers. No association of blood cadmium with self-reported offal consumption could be found. Median urine cadmium concentrations are elevated at 2.3 mumol/mol creatinine and rise substantially with age: 0.9 in the 30-39 age group; 3.2 among the 40-59 age group; and 4.1 in the 60 and over.

Adolescent↗

Pibloktoq (hysteria) and Inuit nutrition: possible implication of hypervitaminosis A.

The hysterical reaction among Eskimo peoples known as pibloktoq, one of a group of aberrant behaviors occurring among Arctic and Circumarctic societies termed 'arctic hysterias', has been explained by a variety of theories: ecological, nutritional, biological-physiological, psychological-psychoanalytic, social structural and cultural. This study hypothesizes the possible implication of vitamin intoxication, namely, hypervitaminosis A, in the etiology of some cases of pibloktoq. Its biocultural approach implicates elements of several explanatory classes, which are not mutually exclusive. Experimental and clinical studies of nonhumans and humans reveal somatic and behavioral effects of hypervitaminosis A which closely parallel many of the symptoms reported for Western patients diagnosed as hysterical and Inuit sufferers of pibloktoq. Eskimo nutrition provides abundant sources of vitamin A and lays the probable basis in some individuals for hypervitaminosis A through ingestion of livers, kidneys, and fat of arctic fish and mammals, where the vitamin often is stored in poisonous quantities. Possible connections between pibloktoq and hypervitamonosis A are explored. A multifactorial framework may yield a more compelling model of some cases of pibloktoq than those that are mainly unicausal, since, among other things, the disturbance has been reported for males and females, adults and children, and dogs.

Animals↗

The other face of development: native population, health status and indicators of malnutrition--the case of the Cree and Inuit of northern Quebec.

The cultural setting of the isolated Cree Indian and Inuit communities is described and measures of their health examined. Questionnaires were employed to consider both epidemiological and socio-cultural facets and physical examination evaluated serological indicators of nutritional status. Changes of lifestyle toward store purchased food and a lessened reliance on hunting and fishing along with the non-native nature of the health services available seem to be leading to heart conditions, hypertension and diabetes all of which give cause for concern.

Adolescent↗

Tobacco-specific nitrosamines in the saliva of Inuit snuff dippers in the Northwest Territories of Canada.

Levels of tobacco-specific nitrosamines (TSNA), nicotine and cotinine were estimated in the saliva of 20 snuff dippers (Inuit, Northwest Territories, Canada). Levels of N'-nitrosonornicotine (NNN), 4-(methyl-N-nitrosamino)-1-(3-pyridyl)-1-butanone (NNK), and N-nitrosoanatabine (NAT) plus N-nitrosoanabiasine (NAB) found in the saliva following a 15-min period of keeping 0.5-1.5 g of moist snuff in the gingival groove are considerable: 115-2610 ppb NNN, 123-4560 ppb NAT + NAB, and up to 201 ppb NNK. The amount of TSNA in the saliva increases with the length of time that the snuff is kept in the mouth. The estimated total amount of 444 micrograms TSNA, the largest part of which will be swallowed, exceeds by far the amounts of nitrosamines ingested through drinking beer (0.34 micrograms/day), eating cured meat products (0.17 micrograms/day), or using cosmetics (0.41 micrograms/day). The relatively high levels of potentially carcinogenic TSNA in the saliva, together with the current popularity of snuff usage by teenagers, is of particular concern.

Canada↗

Hospitalization due to pneumonia among Innu, Inuit and non-Aboriginal communities, Newfoundland and Labrador, Canada.

OBJECTIVES: The objective of this study was to compare hospitalization rates due to pneumonia between Innu/Inuit communities in Labrador and non-Aboriginal communities on the Northern Peninsula of Newfoundland, Canada. METHODS: This is a comparative study using data on hospitalization due to pneumonia for the period from April 1, 1995 to March 31, 2001, for the Innu/Inuit communities in Labrador and a sample of non-Aboriginal communities on the Northern Peninsula of Newfoundland. Data were obtained from the provincial hospital database. Hospitalization rates among the study groups were compared by age, gender, and type of pneumonia. RESULTS: The hospitalization rate due to pneumonia for the Innu/Inuit communities was 11.6 compared to 3.0 per 1000 population for non-Aboriginal communities (p<0.01x10(-4)). Among the Innu/Inuit communities, infants had the highest rate of hospitalization due to pneumonia (93.4 per 1000 population), while the elderly (10.2 per 1000 population) were found to have the highest rate among the non-Aboriginal sample. Overall hospitalization rate for the Innu communities (16.9 per 1000 population) was higher than that for Inuit communities (8.4 per 1000 population) (p<0.01x10(-4)). CONCLUSIONS: Aboriginal communities, particularly the Innu communities, had higher rates of hospitalization due to pneumonia compared to the non-Aboriginal sample. Findings of this study will be used as a foundation for more specific studies in an effort to increase our understanding of pneumonia and associated risk factors.

Adolescent↗