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HBM4EU-MOM: Prenatal methylmercury-exposure control in five countries through suitable dietary advice for pregnancy – Study design and characteristics of participants

2023-06-30Journal article Open access
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dc.contributor.authorKatsonouri, Andromachi
dc.contributor.authorGabriel, Catherine
dc.contributor.authorEsteban López, Marta
dc.contributor.authorNamorado, Sónia
dc.contributor.authorHalldorsson, Thorhallur
dc.contributor.authorSnoj Tratnik, Janja
dc.contributor.authorRodriguez Martin, Laura
dc.contributor.authorKarakoltzidis, Achilleas
dc.contributor.authorChatzimpaloglou, Anthoula
dc.contributor.authorGiannadaki, Despina
dc.contributor.authorAnastasi, Elena
dc.contributor.authorThoma, Anthi
dc.contributor.authorDomínguez-Morueco, Noelia
dc.contributor.authorCañas, Ana
dc.contributor.authorJacobsen, Eva
dc.contributor.authorAssunção, Ricardo
dc.contributor.authorPeres, Maria
dc.contributor.authorSantiago, Susana
dc.contributor.authorNunes, Carla
dc.contributor.authorPedraza-Diaz, Susana
dc.contributor.authorIavicoli, Ivo
dc.contributor.authorLeso, Veruscka
dc.contributor.authorLacasaña, Marina
dc.contributor.authorGonzález-Alzaga, Beatriz
dc.contributor.authorHorvat, Milena
dc.contributor.authorSepai, Ovnair
dc.contributor.authorCastano, Argelia
dc.contributor.authorKolossa-Gehring, Marike
dc.contributor.authorKarakitsios, Spyros
dc.contributor.authorSarigiannis, Dimosthenis
dc.date.accessioned2023-10-09T14:49:57Z
dc.date.available2023-10-09T14:49:57Z
dc.date.issued2023-06-30
dc.description.abstractBackground: Seafood is a major source of vital nutrients for optimal fetal growth, but at the same time is the main source of exposure to methylmercury (MeHg), an established neurodevelopmental toxicant. Pregnant women must be provided with dietary advice so as to include safely fish in their diet for nutrition and mercury control. The aim of this work is to present the design of a multicentre randomized control trial (RCT), which combines human biomonitoring (HBM) with dietary interventions using seafood consumption advice to pregnant women for MeHg control, and to collect information about other possible sources of exposure to mercury. It also presents the materials developed for the implementation of the study and the characteristics of the study participants, which were self-reported in the first trimester of pregnancy. Methods: The "HBM4EU-MOM" RCT was performed in the frame of the European Human Biomonitoring Initiative (HBM4EU) in five coastal, high fish-consuming European countries (Cyprus, Greece, Spain, Portugal and Iceland). According to the study design, pregnant women (≥120/country, ≤20 weeks gestational age) provided a hair sample for total mercury assessment (THg) and personal information relevant to the study (e.g., lifestyle, pregnancy status, diet before and during the pregnancy, information on seafood and factors related to possible non-dietary exposures to mercury) during the first trimester of pregnancy. After sampling, participants were randomly assigned to "control" (habitual practices) or "intervention" (received the harmonized HBM4EU-MOM dietary advice for fish consumption during the pregnancy and were encouraged to follow it). Around child delivery, participants provided a second hair sample and completed another tailored questionnaire. Results: A total of 654 women aged 18-45 years were recruited in 2021 in the five countries, primarily through their health-care providers. The pre-pregnancy BMI of the participants ranged from underweight to obese, but was on average within the healthy range. For 73% of the women, the pregnancy was planned. 26% of the women were active smokers before the pregnancy and 8% continued to smoke during the pregnancy, while 33% were passive smokers before pregnancy and 23% remained passively exposed during the pregnancy. 53% of the women self-reported making dietary changes for their pregnancy, with 74% of these women reporting making the changes upon learning of their pregnancy. Of the 43% who did not change their diet for the pregnancy, 74% reported that their diet was already balanced, 6% found it difficult to make changes and 2% were unsure of what changes to make. Seafood consumption did not change significantly before and during the first trimester of pregnancy (overall average ∼8 times per month), with the highest frequency reported in Portugal (≥15 times per month), followed by Spain (≥7 times per month). During the first-trimester of pregnancy, 89% of the Portuguese women, 85% of the Spanish women and <50% of Greek, Cypriot and Icelandic women reported that they had consumed big oily fish. Relevant to non-dietary exposure sources, most participants (>90%) were unaware of safe procedures for handling spillage from broken thermometers and energy-saving lamps, though >22% experienced such an incident (>1 year ago). 26% of the women had dental amalgams. ∼1% had amalgams placed and ∼2% had amalgams removed during peri-pregnancy. 28% had their hair dyed in the past 3 months and 40% had body tattoos. 8% engaged with gardening involving fertilizers/pesticides and 19% with hobbies involving paints/pigments/dyes. Conclusions: The study design materials were fit for the purposes of harmonization and quality-assurance. The harmonized information collected from pregnant women suggests that it is important to raise the awareness of women of reproductive age and pregnant women about how to safely include fish in their diet and to empower them to make proper decisions for nutrition and control of MeHg, as well as other chemical exposures.pt_PT
dc.description.sponsorshipWe acknowledge funding for HBM4EU from the European Union’s Horizon 2020 research and innovation program under grant agreement #733032 and the national governments of the participating countries. This publication reflects only the authors’ views, and the European Commission is not responsible for any use that may be made of the in formation it contains.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationInt J Hyg Environ Health. 2023 Jul:252:114213. doi: 10.1016/j.ijheh.2023.114213. Epub 2023 Jun 30. Reviewpt_PT
dc.identifier.doi10.1016/j.ijheh.2023.114213pt_PT
dc.identifier.issn1438-4639
dc.identifier.urihttp://hdl.handle.net/10400.18/8677
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.relationEuropean Human Biomonitoring Initiative
dc.relation.publisherversionhttps://www.sciencedirect.com/science/article/pii/S1438463923001049pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/pt_PT
dc.subjectBiomonitorização Humanapt_PT
dc.subjectHuman Biomonitoringpt_PT
dc.subjectHBM4EUpt_PT
dc.subjectHBM4EU-MOMpt_PT
dc.subjectMercúriopt_PT
dc.subjectMercurypt_PT
dc.subjectExposição Pré-natalpt_PT
dc.subjectPrenatal Exposurept_PT
dc.subjectMulheres Grávidaspt_PT
dc.subjectPregnant Womenpt_PT
dc.subjectDesenho do Estudopt_PT
dc.subjectStudy Designpt_PT
dc.subjectDeterminantes da Saúde e da Doençapt_PT
dc.titleHBM4EU-MOM: Prenatal methylmercury-exposure control in five countries through suitable dietary advice for pregnancy – Study design and characteristics of participantspt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.awardTitleEuropean Human Biomonitoring Initiative
oaire.awardURIinfo:eu-repo/grantAgreement/EC/H2020/733032/EU
oaire.citation.startPage114213pt_PT
oaire.citation.titleInternational Journal of Hygiene and Environmental Healthpt_PT
oaire.citation.volume252pt_PT
oaire.fundingStreamH2020
person.familyNameKatsonouri
person.familyNameGabriel
person.familyNameEsteban
person.familyNameNamorado
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person.familyNameSnoj Tratnik
person.familyNameRodriguez Martin
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project.funder.identifierhttp://doi.org/10.13039/501100008530
project.funder.nameEuropean Commission
rcaap.embargofctAcesso de acordo com a política editorial da revistapt_PT
rcaap.rightsopenAccesspt_PT
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