Pregnant Inuit women exposed to higher levels of chemicals found in consumer products: U of T study

Christopher.Sorensen — Mon, 02 Nov 2020 17:16:39 +0000

Christopher.Sorensen Mon, 11/02/2020 - 12:16

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A U of T study found that pregnant Inuit women had concentrations of PFAAs, found in non-stick coatings for cookware and cleaning products, that were twice as high as those in a representative sample of Canadian women (photo by Halfpoint via Getty Images)

Don Campbell

Topic

Breaking Research

Physical and Environmental Sciences

Inuit

Pollution

Quebec

Research & Innovation

Sustainability

U of T Scarborough

Pregnant women living in Nunavik in northern Quebec are increasingly being exposed to potentially harmful chemical compounds commonly found in consumer products.

This is one of the findings of new study by a group of Canadian researchers including Élyse Caron-Beaudoin, an assistant professor in the department of health and society and the department of physical and environmental sciences at the University of Toronto Scarborough.

The study, published in the journal Environment International, focused on perfluroalkyl acids (PFAAs), which are used in a wide range of consumer products including non-stick coatings for cooking ware, water and stain repellents, food packaging, paints, cosmetics and cleaning products. It found that PFAA concentrations in pregnant Inuit women were twice as high as those in a representative sample of Canadian women.

“It’s an environmental injustice because people’s food in the Arctic is being contaminated by chemicals made far away from their homes,” says Caron-Beaudoin, an expert on toxicology as well as public and environmental health.

PFAAs do not biodegrade easily, and as a result, can persist for a long time in the environment. They can also be carried over long distances in the atmosphere and in oceans, where they accumulate in the tissues of living organisms in the Arctic food chain, according to Caron-Beaudoin.

She says that exposure to these compounds, including during fetal development, is associated with changes in hormonal, kidney, cardio-metabolic and immune function.

The study involved measuring changes in the concentration of PFAAs in the blood of 279 pregnant women living in the Nunavik region of northern Quebec from 2004 to 2017. The researchers found that one of the likely sources of PFAAs concentrations in the blood is the consumption of country foods, particularly marine wildlife.

Caron-Beaudoin says that many living in the north experience food insecurity and rely on the nutritional and cultural value provided by country foods, which make up the traditional Inuit diet.

“The benefit of consuming traditional foods still outweigh the negatives,” she says. “[But] we need adequate regulations that protect these country foods from harmful contaminants because these communities rely on them, especially pregnant women who need the nutritional value.”

While most PFAAs are regulated in North America, they do get imported by consumer products that contain them. The researchers found there’s been a drop in concentrations of legacy PFAAs – those banned by various international and North American treaties – but found that concentrations of long-chain PFAAs, which are more recent and can come from the degradation of other currently-used similar compounds such as Fluorotelomer alcohols (FTOHs), are on the rise.

“These long-chain PFAAs are even more persistent and have an even greater potential to accumulate in the food chain than the older PFAAs,” says Caron-Beaudoin.

Caron-Beaudoin says compounds like FTOHs not only travel long distances from their site of production, they also travel in consumer and industrial products that get imported into North America.

“It’s important to stay on top of this and make sure these new chemical compounds are tightly regulated as well,” she says.

U of T's Dr. Barry Pakes reflects on first year as Nunavut’s deputy chief medical officer of health

ullahnor — Fri, 27 Jan 2017 17:18:11 +0000

U of T's Dr. Barry Pakes reflects on first year as Nunavut’s deputy chief medical officer of health

ullahnor Fri, 01/27/2017 - 12:18

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Professor Barry Pakes in Arctic Bay (photo courtesy of Barry Pakes)

Jim Oldfield

Author legacy

Jim Oldfield

Topic

Dalla Lana School of Public Health

Global

Inuit

U of T's Dr. Barry Pakes has been Nunavut’s deputy chief medical officer of health for almost a year.

“It's hard to create comprehensive solutions to complex health problems when you're constantly putting out fires,” says Pakes, an assistant professor at the Dalla Lana School of Public Health.

One of those fires is whooping cough, which this year has sickened more than 130 people and sent several infants to intensive care in Ottawa. Another is a common but serious condition called respiratory syncytial virus. Health officials have recorded 88 new cases since September.

“Nunavut has 37,000 people living in 25 communities on land half the size of Western Europe,” says Pakes, the director of the Global Health Education Initiative and the Public Health and Preventive Medicine (PHPM) residency program at U of T. “The health issues here stem from a complex interplay of cultural, social and historical factors, extreme remoteness and harsh environment, and the dual burden of infectious and chronic diseases in addition to mental health issues.”

Pakes and Dr. Kim Barker, Nunavut’s chief medical officer of health who is also a graduate of the University’s PHPM program, are trying to develop long-term prevention plans for several diseases. The plan for respiratory disease includes widespread vaccination but also better communication among public health workers, hospital staff and primary-care providers.

“One of the first things I did here was start a small brainstorming group of public health and clinical health care professionals,” he says. “The hospital and the Department of Health headquarters were just down the street from each other, but we weren’t problem-solving together like we could have been.”

As Nunavut's deputy chief medical officer of health, Professor Barry Pakes did a radio show on tobacco. Mostly elders called in to ask questions and to describe their personal experiences with quitting (photo courtesy of Barry Pakes)

Pakes says a lot of good has come from the meetings, including new ideas about how to reduce Nunavut’s high number of medical evacuations, which cost tens of thousands of dollars each.

“With more communication, we can better think about how to organize health services and create a web of prevention that saves lives and resources.”

Good communication among the many players in a health system is one lesson Pakes has taken from his years as a global health practitioner and educator. He has been a senior ethics fellow at the World Health Organization and worked in Ethiopia, Zimbabwe and India. He still practices emergency medicine in Northern Ontario and primary care in Barrie.

Pakes’s many roles at U of T – and the five children he has with his wife, who is also physician – now keep in him in Toronto most days. But he spends at least one week a month in Nunavut. He says that being based in Toronto is at times a drawback, but that it also lets him act as a conduit between South and North.

“The frameworks we teach to PHPM residents in Toronto are exactly those necessary to address the complex issues in Nunavut so it’s very rewarding to bring those perspectives – along with the collective knowledge and overwhelming goodwill of public and allied health experts in Toronto,” says Pakes. “At the same time, it’s great to share lessons learned in Nunavut with my colleagues in Toronto and in training the next generation of Canadian public health leaders.”

Pakes is sensitive to the optics around his background and where he spends his time. He says that Nunavummiut generally don’t want to be told how to deal with their problems by people from the South.

“And health issues here are unique,” he adds. “Some paradigms of global health overlap with Indigenous health, but there are important differences.”

Professor Barry Pakes outside the Arctic Bay Health Centre (photo courtesy of Barry Pakes)

Nunavut's high rates of respiratory disease, relative to the rest of the world, stem in part from overcrowding and smoking in homes. And the mental health issues many residents face – suicide rates in Nunavut are 10 times higher than in the rest of Canada – likely have some roots in Canada's residential school system and the forced displacement of communities, which separated families and pushed many Inuit off their land.

Emma Mew is a master's student in epidemiology at the Dalla Lana School of Public Health. Last summer she worked as a public health consultant in Nunavut, helping the territorial government start to develop a mental health monitoring system to identify at-risk youth and prevent suicide, which in Nunavut often happens in clusters.

“I don’t want to speak on behalf of Inuit, but I gather their experience of colonization has been different from other populations,” says Mew. “Inuit identity is closely tied to the land so forced relocation together with complex social factors likely affect Inuit mental health and wellness profoundly.”

Mew has worked in Tanzania and interned at the World Health Organization, but she says getting things done in Nunavut was harder than anywhere she has worked.

“My department was very cross-cultural, and I feel privileged to have learned so much about Inuit culture from my co-workers. But across the territory, the health workforce is transient – six months is considered long-term – and my impression is that this can exacerbate the divide between Inuit and non-Inuit."

Pakes says that even after ten years of research and a PhD in public health ethics, the ethical dilemmas in Nunavut are some of the most challenging he has faced.

“Inuit culture and self-governance are critically important to every health issue. For example, ‘country food’ and the connection to the land are paramount. So solutions for food insecurity and poor housing that make sense in urban and warmer areas don’t work in the Far North.”

He had a cross-cultural ‘aha’ moment recently while exchanging photos with an Inuit colleague. He proudly showed her a photo of his children, and she responded in kind with a picture of her grandchildren at a feast – two smiling toddlers with their faces covered in seal blood.

And then there is Nunavut’s physical remoteness. It often limits access to health services and online mobile technologies that are improving health globally because satellite Internet access is spotty and slow.

But Pakes says Nunavut's cultural vibrancy and diversity make up for many of its geographical and technological challenges. He says people are surprised when he tells them that Nunavut is probably the most ‘uniquely Canadian’ place he has worked. Iqaluit is home to a flourishing Inuit culture but also a new mosque and many recent immigrants including Cameroonians and a sponsored Syrian family.

"Most days – and daylight can last 18 hours – I feel I can make a real difference,” says Pakes. “And not just for one person but for entire communities. That’s the incredibly rewarding thing about public health.”