OBJECTIVE:
To promote country foods in the Dehcho Region in a way that balances contaminant risks and nutrient benefits in order to maximize nutrient status while minimizing mercury exposure.
PROJECT:
The overall objective of this research is to promote country foods in the Dehcho Region in a way that balances contaminant risks and nutrient benefits in order to maximize nutrient status while minimizing mercury exposure. The research team will work towards this objective through the implementation of research that will consist of the bio-monitoring study to evaluate country food usage patterns, contaminant exposure profiles and nutritional biomarkers of participating communities. This will allow for the creation of a public health screening tool that will be used to characterize those most at risk of facing elevated contaminant exposures in the Mackenzie Valley.
The research team will travel to the Mackenzie Valley to continue the consultation process started in 2014. Every community in the Dehcho Region, Sahtu Region and in Hay River will be consulted during the project. Consultations happen through phone meetings with leaders, face-to-face meetings with the leadership and public meetings for community members. In the fall of 2016, the research team traveled again to implement sample and data collection in the communities accepting to participate (about 3 communities). Blood, urine, and hair sampling began in the Jean Marie River community in January 2016. To facilitate the blood/urine/hair sampling, we coordinated with each band office for rental of space in each participating community for 2 to 4 days. The Dehcho Health and Social Services Authority (DHSSA), the Sahtu Health and Social Services Authority (SHSSA) and the Hay River Public Health Department agreed to support this bio-monitoring project (which will measure metals, organic pollutants, hair Hg, and nutritional biomarkers) by making nurses available for blood sample collection. In consultation with community partners, a local research coordinator will assist with participant recruitment. All community members over 6 years of age will be eligible to participate regardless of age, sex, family, parity status or other characteristics. Before participating in the project, each participant will be required to read an information letter before signing an informed consent form. Importantly, each participant will be provided the choice to only take part in the project components in which they are interested. For example, one individual may choose to provide dietary information and hair but not provide blood.
In addition to blood, urine, and hair sampling, each participant will be asked to complete two dietary surveys. For the first survey, participants will be asked to detail what they have eaten over the prior 24 hours. This 24-hr recall will also be used to generate the portion size information necessary to estimate nutrient and contaminant intakes for the second dietary survey, a Food Frequency Questionnaire (FFQ). For the FFQ, participants will be asked to use an iPad app, QuickTapSurvey (www.quicktapsurvey.com), to document their country food use over the previous year.
The biological sample was distributed to specific project members to undergo chemical analysis. Hair samples underwent analysis for total mercury in the laboratory of Michael Power in the Department of Biology at the University of Waterloo. Blood and urine samples were analyzed at the Université de Montréal by Michele Bouchard in the Department of Environmental and Occupational Health. Plasma samples were analyzed at the Institut national de santé publique du Québec. Lastly, the fatty acid composition of whole blood were determined by Ken Stark in the Department of Kinesiology at the University of Waterloo.
Participants received a letter with their individual results 6 to 10 months after providing samples. The research team returned to communities 9 to 12 months after data and sample collection to hold a public meeting to present the results. The team is currently creating a survey on Risk perception and messaging efficiency to support the development of efficient means to communicate the bio-monitoring results and on country foods messages. Participants will be requested to complete the third survey. A Committee was created to assist with the messaging strategy, and involves local collaborators, scientists, and government partners.
Northern Contaminant Program funds were used to translate every document the leadership recommended be translated. The translator assisted according to the advice of the community and local partners. For public meetings, the rental of the hall and the support of a translator were included in the request for funding.
The team will have a local research coordinator in each of the participating communities. These coordinators would assist with the implementation of the project by overseeing participant recruitment and assist participants in completing the surveys. For the recruitment stage, the coordinators’ work would include: contacting potential participants, explaining the objectives of the study and obtaining informed consent. During the data collection stage, the coordinators’ work would include the sampling of hair for chemical analysis, preparing samples for storage/shipment, and assisting participants in the completion of the electronic dietary surveys. Each coordinator will receive training on participant recruitment, hair sampling, dietary survey implementation of the questionnaire. Additionally, in each community, the research team hope to hire a computer-savvy, local young person to help create a social media presence for the study. This individual could help us make sure community members are aware of when we’re arriving to do the research, when we’re coming back to return results, and to maintain contact with participants in between sample collection and the return of results.
Furthermore, Laird and Swanson have received a grant from the Natural Sciences and Engineering Research Council of Canada for the purchase of a field-portable mercury analyzer. The research team will include this equipment within the chemical analysis plan for the bio-monitoring project. Such a piece of equipment would facilitate exciting avenues for participatory research by enabling local community members to be trained in not only the collection of hair samples but also the analysis of mercury content within those hair samples. We will design a training program by which community members can be trained on the measurement and interpretation of mercury levels in human hair.
Each study participant that provided a hair and/or blood sample will receive by mail a confidential, plain-language letter detailing their contaminant exposure levels.
Each study participant that provided a hair, urine and/or blood sample will receive by mail a confidential, plain-language letter detailing their contaminant exposure levels. The letters will compare their blood mercury, cadmium and lead levels to the average levels of other Canadian populations, and relevant biomonitoring trigger guidelines. The individual results follow-up letters, which will be designed in consultation with the regional health authorities and local collaborators will emphasize the general healthfulness and importance of country foods. In parallel with the individual reporting, the research team will form a Committee to guide the knowledge translation of the community-level results via: a) the creation of plain-language community reports and b) hosting public forums in each participating community. These community-level reports would only include aggregate data and could not be used to identify the results of any one individual. Furthermore, in the last year, the research will aim to create a screening tool to identify individuals within the Northwest Territories who are most at risk of contaminant exposure.
The fieldwork for this study was conducted from January 7, 2018, to December 31, 2018.
RELEVANT LINKS
Websites
Articles
- Ratelle, M., Laird, M., Majowicz, S., Skinner, K., Swanson, H., & Laird, B. (2018). Design of a human biomonitoring community-based project in the Northwest Territories Mackenzie Valley, Canada, to investigate the links between nutrition, contaminants and country foods. International Journal of Circumpolar Health, 77(1), 1510714.
- Ratelle, M., Skinner, K., Laird, M. J., Majowicz, S., Brandow, D., Packull-McCormick, S., ... & Hanning, R. (2018). Implementation of human biomonitoring in the Dehcho region of the Northwest Territories, Canada (2016–2017). Archives of Public Health, 76(1), 73.
- Laird, M. J., Henao, J. J. A., Reyes, E. S., Stark, K. D., Low, G., Swanson, H. K., & Laird, B. D. (2018). Mercury and omega-3 fatty acid profiles in freshwater fish of the Dehcho Region, Northwest Territories: Informing risk benefit assessments. Science of The Total Environment, 637, 1508-1517.