The legacy of mercury poisoning in Grassy Narrows First Nation Donna Mergler CINBIOSE, Université du Québec à Montréal Judy DaSilva Asubpeeschoseewagong Netum Anishinabek (Grassy Narrows First Nation) Myriam Fillion Université TÉLUQ Aline Philibert CINBIOSE, Université du Québec à Montréal First Nations Food, Nutrition and Environment Forum Ottawa, November 5 2019
You cannot talk about the people without talking about the land from which they come from.
The Grassy Narrows community fights for recognition and their rights
Health assessments • 1979: Neurological examinations “ revealed effects that may be associated with methylmercury poisoning but a definitive diagnosis remained elusive”. (Wheatley, 1979) • 1986: Dr. Brian Postl examined Grassy Narrows’ morbidity and mortality records from the local hospital. The report indicated that the community “experienced illness and death at rates which far exceed district, provincial and national standards”. 1975 – 2011: Dr. Masazumi Harada and his team examined persons at four • occasions and reported many cases of clinical Minamata Disease and Minamata Disease with complications. In 2015 - 2018: Grassy Narrows carried out a community-based health • assessment.
Grassy Narrows’ Community Health Assessment Community-driven survey: community participation in all aspects • Questionnaire was adapted from the First Nations Regional Health Survey, • including new questions (e.g. fish consumption, neurological conditions) Computer-based survey between December 2016 and March 2017 • 9 community surveyors going house-to house • Participation rate: 78% - 424 adult and 353 children • 2 main questions 1. How does the health and well-being of Grassy Narrows First Nation fare in comparison with other First Nations? 2. Do past and present fish consumption, which are indicators of mercury exposure, contribute to poor health and well-being? Financial support : Health Canada and Ontario Ministry for Health and Long-term Care
How does Grassy Narrows First Nation fare in comparison with other First Nations? Ontario Canada
Comparison with other First Nation communities Thriving (health perception: very good or excellent) 60%$ 44%$ 40%$ 21%$ Grassy$Narrows$ First$Na3ons$in$ First$Na3ons$in$ Canada$ Ontario$ Canada$ • This is mirrored in the percentage of those who have at least one chronic health condition. • Diabetic co-morbidity is more frequent in Grassy Narrows, despite the fact that proportionally more diabetics in Grassy Narrows attend clinics or education
Comparison with other First Nation communities 41%$ Not working because of a disability 22%$ 21%$ or health or mental problem among the unemployed Grassy$Narrows$ First$Na1ons$in$ First$Na1ons$in$ Ontario$ Canada$ 54%$ 40%$ 37%$ Struggle to pay for food at least a few times a year Grassy$Narrows$ First$Na3ons$in$ First$Na3ons$in$ Ontario$ Canada$ 24%$ 15%$ Severe food insecurity 13%$ Grassy$Narrows$ First$Na3ons$in$ First$Na3ons$in$ Ontario$ Canada$
Comparison with other First Nation communities 33% Family member or close friend committed suicide 13% 7% Grassy Narrows First Na1ons in First Na1ons in Ontario Canada 37% Suicidal ideation 25% 22% Grassy Narrows First Na2ons in First Na2ons in Ontario Canada 28% Attempted suicide 13% 13% Grassy Narrows First Na2ons in First Na2ons in Ontario Canada
Children less than 12 years of age First First Grassy Nations Nations Narrows in Ontario in Canada Low birth weight (<2.5 kg) 4% 5% Breastfed 63% 65% 60% Thriving (health excellent or very good) 73% 85% 88% Mental health (very good/excellent) 52% 65% Chronic ear infections or ear problems 17% 7% 6% Speech / language difficulties 11% 6% 5% Learning disability 9% 4% 3% Conditions impact school performance: 6 – 11y 19% 7% Emotional or behaviour problems: 3 – 11 y 27% 15% 14% Emotional or behaviour problems: 9 – 11 y 37% 18%
Youth 12-17 years of age Grassy First First Nations Nationss Narrows in Ontario in Canada Allergies 13% 18% 16% Asthma 13% 15% 13% Anaemia 11% 2% Chronic ear infections 23% 7% 3% Dermatitis 14% 4% 4% Conditions that impact school performance 16% 7% Attends school 91% 88% Difficulty in school 52% 39% Short attention span 32% 21% Too many distractions 59% 39% Difficulty understanding 37% 28%
Do past and present fish consumption, which are indicators of mercury exposure, contribute to their poor health and well-being? Mercury exposure A continuum of severity of effects Subtle changes Obvious Clinical mercury which impact symptoms of poisoning: individuals and nervous system a progressive the community dysfunction neurologic disorder
Fish consumption: indicators of mercury exposure Adults: • How much fish did you eat when you were 10 years old? At least several fish meals a week vs. fewer • How much walleye did you eat over the past year? Often: (median 3 fish meals/month) A few times or never (median 1 fish/month) Children: How much fish did you (mother) eat when you were pregnant with • this child ? Never/hardly ever; once a month; once a week or more
Adults Significant dose-related associations were observed between symptom • clusters and reported childhood and/or current fish consumption for: – Paresthesia in extremities – Motor difficulties – Difficulty swallowing, stumbling, falls – Loss of memory, difficulty concentrating – Anxiety, depression Taking into account as required: age, sex, at least one chronic health condition, alcohol use, smoking, nutrition, mother in residential school
Adults For persons 18-49 years of age, • childhood fish consumption was associated with: – Perceiving their health as poor – Having done fairly/poorly in school – Income less than $20,000/y – Struggle to pay for food For persons 50+ years of age: • – 50% had been told by a health professional that they had mercury poisoning Results of mutiple regression models, taking into account, as required: age, sex, at least one chronic health condition, alcohol use, smoking, nutrition, obesity, parent in residential school
Child/youth (4 -17 years) health conditions 1 with respect to maternal fish consumption during pregnancy 1 fish meal/ 1 fish meal/ month week or more Health less than very good or excellent X (not thriving) Chronic diagnosed conditions Visual problems -------X------- -------X------- Chronic ear infections Learning/speech disability X At least one nervous system disorder X Conditions that may impact school X performance 2 1. Models include: mother’s alcohol consumption during pregnancy, gestational diabetes and/or hypertension, difficulties at childbirth and child’s age and sex 2. Measure used by the First Nations Regional Health Survey 2008/2010 for children: includes having one of the following conditions: cognitive or mental disability, a learning disability, ADD/ADHD or speech and language difficulties
Question: “ Did the child/youth have more emotional or behavioural problems compared to other children of the same age and sex over the past 6 months?” Maternal fish consumption during pregnancy
Conclusions of the Grassy Narrows Community Health Assessment (2018) • Grassy Narrows First Nation has poorer physical and mental health, and more socio-economic difficulties compared to other First Nation communities in Ontario and in Canada. • Fish consumption, particularly during childhood, significantly contributes to poor health and well-being of individuals and the community. • The specific deficits and the long-term effects of childhood exposure are consistent with the scientific literature on the detrimental effects of mercury on health.
Recommendations Remediation: elimination of mercury from the lakes, rivers and fish. • Increased funding and appropriate programs for physical and • mental health. A long-term care facility on reserve that addresses the issues of • mercury poisoning, with appropriate out-patient services for those with symptoms (e.g. physiotherapy, vision care, cognitive stimulation…). Programs for food security, with access to healthy food, including • uncontaminated walleye. Long term, stable institutions to facilitate the sharing of knowledge, • culture and traditional healing by Grassy Narrows should be supported and augmented.
Current studies with Grassy Narrows Examine premature mortality (<60 years) with respect to longitudinal • exposure to mercury Verify the findings of the CHA using longitudinal biomarker data • Analyze mercury distribution in the brain and other organs from • autopsies performed on people from Grassy Narrows
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