First Nations Biomonitoring Initiative: National Results 2011 by … · 2017. 7. 20. · National Results (2011). Assembly of First Nations, 2013. Print. About the Assembly of First

First Nations Biomonitoring Initiative: National Results 2011 by the Assembly of First Nations.

Copyright © National Indian Brotherhood, 2013

This report can be cited as:

Stuart Wuttke, Elsa LaCorte, Diego Garcia, and Maria Ooi. First Nations Biomonitoring Initiative: National Results (2011). Assembly of First Nations, 2013. Print.

About the Assembly of First Nations

The Assembly of First Nations (AFN) is the national, political representative of First Nations governments and their citizens in Canada, including those living on reserve and in urban and rural areas. Every Chief in Canada is entitled to be a member of the Assembly. The National Chief is elected by the Chiefs in Canada, who in turn are elected by their citizens.

The role and function of the Assembly is to serve as a national delegated forum for determining and harmonizing effective collective and co-operative measures on any subject matter that the First Nations delegate for review, study, response or action, and ultimately for advancing the aspirations of First Nations.

For more information, please contact us at: 55 Metcalfe Street, Suite 1600 Ottawa, Ontario K1P 6L5

Telephone: 613-241-6789 Toll-Free: 1-866-869-6789 Fax: 613-241-5808 or visit the AFN Web site: www.afn.ca

first nations biomonitoring initiative

table of contents

Foreword by national chieF shawn a-in-chut atleo 10

1. research team 11

1.1 research team ....................................................................................................................... 11

1.2 acknowledgements ................................................................................................................ 12

2. executive summary 13

2.1 results ..................................................................................................................................... 13

3. introduction to biomonitoring 15

4. background and rationale 16

4.1 First nation ownership of data: .......................................................................................... 17

5. survey design 18

5.1 Pilot study .............................................................................................................................. 18

5.2 target Population and selection criteria ............................................................................ 18

5.3 methodology .......................................................................................................................... 18

5.4 limitations ............................................................................................................................. 18

5.5 Fieldwork and laboratory analysis ..................................................................................... 18

5.6 data collection ....................................................................................................................... 19

5.7 reporting results to Participants: ....................................................................................... 19

5.8 considerations for interpreting the biomonitoring data4: ............................................... 19

5.9 data analysis .......................................................................................................................... 20

6. ethical considerations 22

7. chemicals measured 23

national results

8. results by chemical grouP: metals and trace elements 24

8.1 antimony ................................................................................................................................ 24

8.2 arsenic .................................................................................................................................... 32

8.3 cadmium ................................................................................................................................ 43

8.4 copper .................................................................................................................................... 54

08.5 lead ....................................................................................................................................... 66

8.6 manganese .............................................................................................................................. 77

8.7 mercury ................................................................................................................................... 88

8.8 molybdenum ......................................................................................................................... 103

8.9 nickel .................................................................................................................................... 115

8.10 selenium ............................................................................................................................. 126

8.11 uranium .............................................................................................................................. 138

8.12 vanadium ............................................................................................................................ 149

8.13 Zinc ..................................................................................................................................... 157

8.14 organochlorines ................................................................................................................ 171

8.14.1Aldrin........................................................................................................................................................171

8.14.2Chlordane................................................................................................................................................179

8.14.3Dichlorodiphenyltrichloroethane(DDT).........................................................................................211

8.14.4Hexachlorobenzene..............................................................................................................................226

8.14.5Hexachlorocyclohexane.......................................................................................................................234

8.14.6Mirex.........................................................................................................................................................248

8.14.7Toxaphene................................................................................................................................................256

8.15 Polychlorinated biphenyls (Pcbs) ................................................................................... 271

8.16 Polybrominated Flame retardants .................................................................................. 423

8.17 Perfluorinated compounds (PFcs) ................................................................................. 485

8.18 environmental Phenol ....................................................................................................... 515

8.18.1BisphenolA..............................................................................................................................................515

8.19 organophosphate insecticides ......................................................................................... 524

8.20 Pyrethroid insecticides ...................................................................................................... 562

8.21 Phenoxy herbicide ............................................................................................................ 595

8.21.12,4-DichlorophenoxyaceticAcid(2,4-D)..........................................................................................595

8.22 chlorophenol ..................................................................................................................... 603

8.22.12,4-Dichlorophenol(2,4-DCP)...........................................................................................................603

8.23 tobacco ............................................................................................................................... 611

8.23.1Cotinine...................................................................................................................................................611

8.24 Phthalates ........................................................................................................................... 624

8.25 conclusion .......................................................................................................................... 695

first nations biomonitoring initiative

aPPendices 697

appendix 1: First nations biomonitoring initiative Pilot study: design and lessons learned ........................................................................................ 697

appendix 2: sampling location within ecozones ............................................................................. 700

appendix 3: household Questionnaire ............................................................................................ 701

appendix 4: report of measurements ............................................................................................. 712

appendix 5: Fnbi sample collection Procedure. ........................................................................... 713

appendix 6: list of chemicals measured in the Fnbi .................................................................... 714

appendix 7: limits of detection (lod) for environmental chemicals measured in the Fnbi .................................................................................................. 717

appendix 8: individual consent Form .............................................................................................. 721

appendix 9: acronyms and abbreviations ....................................................................................... 723

appendix 10: Fnbi report on the weighting Process and variance estimation ......................... 724

appendix 11: Fnbi sample design .................................................................................................. 730

appendix 12: creatinine .................................................................................................................... 733

10 national resultsnational results

IamdelightedtointroducethisreportonbiomonitoringthatistheresultofcollaborativeworkbetweentheAssemblyofFirstNations,HealthCanada'sFirstNationsandInuitHealthBranch,andFirstNationcommunitiesacrossCanada.Thisisatimelyandusefulreport,whichprovidesbaselinedataonenvi-ronmentalcontaminantsfoundintheFirstNationon-reservepopulationacrossCanada.

TheFirstNationsBiomonitoringInitiativehasbeenavaluabletoolinstartingtoaddressthegapinknowledgeabouttheexposureandconcentrationsofenvironmentalcontaminantsinFirstNationpeople.ThisisthefirststudyofthistypetofocusspecificallyonFirstNationpeoplelivingon-reservethatisdoneonarepresentativecross-countryandecozonescale.Thedatacontainedinthisreportwillserveasareferenceforfutureresearchtodeterminechangesintheenvironment,increasesordecreasesintheconcentrationsofchemicalsofconcern,andpotentiallycontributetopublicpolicyontheuseofvariouschemicalsforindustrialorpersonaluseinCanada.

TheFirstNationsBiomonitoringInitiativeexaminesthepresenceofninety-sevenmetalsandchemicals.TheseincludeemergingcontaminantsofconcernsuchasbisphenolA(BPA),fireretardants,andchemicalsforwhichexposureguideline

levelshavenotyetbeenset.Thereportrecognizesthatthereismorethatweshouldlearnaboutexposuretohouseholdandindustrialchemicals.TheAFNisconfidentthattheresultsofthisInitiativewillcontributetotheemergingscienceandresearchbeingconductedinsimilarprojectsthroughouttheworld.ThisreportalsoidentifiescertaingapsthatwillrequireadditionalresearchbyFirstNationsandgovernmenttopursueaspartofcontinualeffortstorefinetheevidence-basedknowl-edge,essentialtosupportsoundpolicy-making.Anessentialtaskforthenearfutureistoensurethatourchildren'shealthisprotectednow,bydevelopingbetterknowledgeoftheirexposuretopotentiallyharmfulchemicals.

TheFirstNationsBiomonitoringInitiativeinvolvedfifteenFirstNationcommunitiesinallaspectsoftheproject,includingtheplanning,fieldwork,andprovidingCommunityResearchAssistantstoconductthesurveys.TheintegralinvolvementofFirstNationsintheBiomonitoringInitiativehasmeantthatFirstNations’questionsandconcernsarebeingaddressedinascientificallyvalidprocess.FirstNationcommunitieswillbeabletousethefindingsofthisreporttomonitorchangestotheirenvironmentandthebaselinedatacanbeusedtomoni-torchangesinexposureasaresultofindustrialdevelopmentandnewprojects.

IwouldliketothanktheFNBIresearchteamandallFirstNationsandindividualswhoparticipatedintheFirstNationsBiomonitoringInitiative.TheAFNwaspleasedtoconductthisstudyandwelookforwardtoHealthCanada’scontin-uedcommitmenttoaddressingFirstNations’environmentalandhealthconcernsbysupportingresearchprojectsthatareconductedinfullpartnershipwithFirstNations.TheFirstNationsBiomonitoringInitiativeprovidesbenefitsforallandIhopethateveryonetakesadvantageofthemanyopportunitiesprovidedbythisreport.

by national chief shawn a-in-chut atleo

f o r e w o r d

11first nations biomonitoring initiative

1.1 research team

1.1.1 assembly of First nationsStuart Wuttke,B.A.,LL.B.,LL.M.PrincipalInvestigatorMr.StuartWuttkeispresentlyGeneralCounselfortheAssemblyofFirstNations.Mr.Wuttkeoverseesalllegalmattersandcom-plianceissuesfortheAssemblyofFirstNations,anditsrelatedsubsidiaries.HewascalledtotheBarin1996.Priortothisrole,Mr.WuttkeservedastheDirectorofEnvironmentalStewardshipattheAssemblyofFirstNationsfrom2006to2010.Duringthisperiod,Mr.WuttkehasworkedonanumberofenvironmentalresearchprojectswithFirstNationcommunitiesrelatingtocontaminantsandenvironmentalimpacts.Hisworkintheen-vironmentalfieldextendedtobothdomesticandinternationaldialoguesinavarietyofsubjects.Mr.Wuttkewasinstrumentalintheestablishmentofa10yearFirstNationstraditionalfoodandcontaminantsstudyandthedevelopmentoftheFirstNationsBiomonitoringInitiativefortheAssemblyofFirstNations.

Elsa La Corte,BEng,MEngPolicyAnalystAskilledenvironmentalprofessionalwithaMaster’sdegreeinEnvironmentalEngineeringandaBachelor’sdegreeinChemicalEngineering.Herprofessionalexperienceincludesthefoodmanufacturingindustrydevelopingnewformulationprotocolsandqualitysamplingandcontrol;inthebeveragemanufactur-ingindustryasaprocessanalystandtechnical/trainingwriter.InhercurrentpositionasaPolicyAnalystattheAssemblyofFirstNationsshehasworkedundertheenvironmentalhealthfile,responsiblefortheFirstNationsBiomonitoringInitiative(FNBI),supportingtheNationalFirstNationsEnvironmentalContaminantsProgram(NFNECP),amongothers,andhasrecentlyjoinedtheAFN’swatermanagementunit.

Diego Garcia,M.D.,M.P.H.PublicHealthAdvisorAmedicalprofessionaltrainedinEmergencyMedicineandPublicHealth.HispreviouspositionsincludecoordinatingandimprovingpublichealthprogramsdeliveryacrossruraljurisdictionsinVenezuela;diseasesurveillanceandimmuniza-tionsofficerfortheWorldHealthOrganizationinAngola;and,currentlyworkingasthePublicHealthAdvisorandEnvironmentalHealthleadfortheAssemblyofFirstNationsinOttawa.ThroughouthiscareerDr.Garciahasgainedadeep

understandingoftheissuesandchallengesinvolvedinhealthservicedeliverytoremoteandindigenouspopulations.

Jarrett LaughlinSeniorResearchAnalystMr.LaughlinworksasaSeniorResearchAnalystattheAssemblyofFirstNations.Hehasco-chairedthenationalworkinggroupfortheBandOperatedFundingFormulaandhasworkedwithseveralorganizationstodevelopFirstNationseducationfundingmodels.Mr.LaughlinhasrecentlyworkedfortheCanadianCouncilonLearningidentifyinginnovativeandholisticapproachestomeasuringsuccessforFirstNations,Inuit,andMétislearning.

1.1.2 health canada / technical advice

Maria OoiHead,BiomonitoringProgram,FirstNations&InuitHealthBranch,HealthCanadaMs.Ooiisanenvironmentalhealthspecialist,withover17yearsofexperienceinthisfield.Inhercurrentposition,sheisinvolvedinenvironmentalhealthsurveillanceandmonitoringprograms,focusingonenvironmentalcontaminantsandtheirimpactstohumanhealth.Aswell,Ms.Ooihasbeenengagedincommunity-basedmonitoringandresearchwithFirstNations.Priortothisposition,shehasworkedasanenvironmentalhealthadvisorforover10yearswithHealthCanadawheresheacquiredin-depthknowledgeofenvironmentalassess-mentsandthehealthimpactsassociatedwithdevelopmentprojects.Whilelivingabroad,Ms.OoiworkedforHabitatforHumanity,toimproveenvironmentally/energyefficienthomesandspearheadthemovetoestablishanaffiliates’network.

Bill Martin,BScEnvironmentalHealthScientist,HealthCanadaMr.Martinisanenvironmentalscientistwithexpertiseinenvi-ronmentalcontaminantsandexposureassessment.InhisformercapacityasanenvironmentalchemistwithEnvironmentCanadaandasaresearchtechnicianwiththeDepartmentofFisheriesandOceans,hehasexperienceinlaboratoryandfieldwork,analysingenvironmentalsamplesincontaminantmonitoring,andconductingtoxicologicalexposureassessments.Mr.Martinalsohasworkedonsafetyassessmentsforchemicalcontaminationofimportedfoods,andenvironmentaleffectsmonitoringpolicy.Hehasrecentlyacceptedanewchallenge,andcontinuestosupporttheFNBIwhilemanagingaPublicHealthprogramforHealthCanada’sFirstNationsandInuitHealthBranch.

c h a p t e r o n eresearch team

12 national results

1.2 acknowledgements

TheAssemblyofFirstNationswouldliketoexpressitsdeep-estappreciationtotheFirstNationcommunitiesthatpartici-patedinthesurveyandacknowledgethatthissurveywouldnothavebeenpossiblewithouttheirgeneroussupportandcommitment.TheAssemblyofFirstNationswouldalsoliketoofferitsspecialthankyoutoalltheFirstNationindividualswhoparticipatedinthissurvey.Theirvaluablecontributionsarereflectedthroughoutthisreport

Inaddition,theAssemblyofFirstNationswouldliketothankthefollowingorganizationswhohaveprovidedourresearchteamwithvaluabletechnicalsupportandadvice:

InstitutnationaldesantépubliqueduQuébec(INSPQ)-CentredetoxicologieduQuébec(CTQ)

• AlainLeBlanc

• MarioMarchand

• ClaudeThellen

SocialSurveyMethods,StatisticsCanada

• ValérieBizier

• CraigSeko

EnvironmentalPublicHealthDivision,FirstNationsandInuitHealthBranch,HealthCanada

• RoyKwiatkowski

• DianeMcClymontPeace

• Dr.ConstantineTikhonov

• Regionalstaff

HealthyEnvironmentsandConsumerSafetyBranch,HealthCanada

• DougHaines

• EllenLye

• LeonoraMarro

• NellieRoest

• Allindividualchemicalspecialists

TheAssemblyofFirstNationsappreciatesthegenerousfinan-cialsupportoftheFirstNationsandInuitHealthBranch,whoprovidedfundingforthisstudy.

Finally,theAssemblyofFirstNationswouldliketoextenditsap-preciationtothepeerreviewersforvolunteeringtheirtimeandgenerouslysharingtheirscientificknowledgeandexpertise.


TheFirstNationsBiomonitoringInitiative(FNBI)seekstoestablishbaselineinformationonhumanexposuretoenviron-mentalchemicalsforFirstNations’peopleon-reservesouthofthe60°parallel.FirstNationshavebeenconcernedabouttheimpactsofenvironmentalpollutionandtheuseofindustrialandhouseholdchemicalsonthehumanpopulation.However,verylittleisknownabouttheeffectsofalargenumberofenvironmentalchemicals,orwhatthecombinationsofthesechemicals,mighthaveonthehumanbody.Inaddition,thereislittleinformationaboutthesechemicalsandtheirconcentra-tionsthatmaybepresentinFirstNationpopulations.TheFNBIattemptstofillthisgapinknowledge.

FirstNationscontinuetorelyonthelandandtheenvironmentforcultural,spiritualandnutritionalpurposes.ThisattachmentispresumedtoincreaseFirstNations'exposuretoenviron-mentalchemicalsandthehealthrisksthesechemicalsmayimposeonindividuals.Untilnow,verylittleornonationallyrepresentativeinformationexistsonFirstNationsexposuretoenvironmentalchemicals,makingthisInitiativethefirststudyofitskindinCanada.ThisstudyisalsothefirstbiomonitoringinvestigationunderthecompletecontrolandauthorityofFirstNations,demonstratingthelevelofcommitmentandrespon-sibilitythattheFirstNationleadershipcanundertaketowardtheprogressandwell-beingoftheirpeoples.

TheFNBIinvolvedatotaloffifteenFirstNationcommunitiesacrossCanada.Twoofthesecommunitieswereinvolvedasapilotstudy.TheremainingthirteenFirstNationcommunitieswereselectedthrougharandomdraw.Fortytwoparticipantspercommunitywereselectedforparticipationinthesurveyduringthesummer/fall2011.Theparticipantscompletedaphysicalexaminationwithanthropometricandclinicalinforma-tioncollection;ahouseholdquestionnairetoassessrisk,expo-sureandutilizationofthechemicalsinthestudy;andprovidedabiologicalspecimenofbloodandurine.Thebiologicalspeci-mensweresubsequentlyanalyzedbyacertifiedlaboratory.Datawascollected,aggregatedandanalyzedinspring2012andresultscontainedinthisreport.

Thisstudywasguidedby Tri-Council Policy Statement - Ethical Conduct for Research Involving Humans,fromHealthCanadaandthePublicHealthAgencyofCanada'sResearchEthicsBoard.TheFNBIwillprovideimportanthealthinformation

toadvancehealthsurveillanceandresearchinCanada,whileprovidingtrainingopportunitiestoFirstNations’peopletoenhanceresearchcapacity.TheFNBIestablishesbaselinedataforfutureusebypublichealthdecision-makersandscientiststohelpFirstNationsfocusonspecifichealth-relatedissues.

2.1 results

DatawerecollectedfromthirteenrandomlyselectedFirstNationcommunitiesinCanada.Ineachcommunity,upto42people,20yearsofageorabovewereselected.Womenwhowerepregnantandthoseindividualsundergoingchemo-therapywereexcludedfromthestudy.Intotal,therewere503FirstNationindividualswhoparticipatedinthestudy.Theoverallparticipationratewas92%.Resultsproducedbythestudywerereturnedtoparticipantsafteranalysis,unlesstheyhadexpressedadesirenottoreceivethemduringsampling.Aswell,earlynotificationtoparticipantswasdoneincaseswhereparticipants'resultsexceededtheCanadianbloodleadinterventionlevelof10microgramsperdeciliter(μg/dL)(setbytheCommiteeforEnvironmentalandOccupationalHealth(CEOH)in1994)orthebloodmercuryguidancevalueof20μg/Lforadults(HealthCanada,2004).Cadmiumwasalsoreportedtoparticipantsiftheyexceededtheoccupationalguidelineforbloodcadmiumof5μg/L(INSPQ,2008).

The97environmentalchemicalsexaminedundertheFNBIwereselectedfromacandidatelistofover200individualchemicalsand/orgroups.Thosethatwereselectedwerebasedonconsid-erationssuchassuspectedhealthrisks,levelofpublicconcernandcomparabilitywithotherstudies.TheFNBIexaminedthefollowing:tracemetals,polychlorinatedbiphenyls,polybromi-nateddiphenylethers,organochlorinepesticides,perfluorinatedcompounds,environmentalphenol,phthalates,pesticides,andcotinine(ametaboliteofnicotine).TheFNBIwasadministeredusingreliablemethodologies.Appropriatelipidorcreatinineadjustmentsforsamplelevelshavebeenmade.

TheresultsoftheFNBIarepresentedatanationalaggregatelevelandecozonelevels.Therewerefiveecozones,whereaminimumoftwocommunitieshadtobesampledineachstratumtoallowforvarianceestimation.Ecozoneswereutilizedonthepremisethatcertaincontaminantscouldbe

executive summary c h a p t e r t w o

14 national results

morepronouncedincertaingeographicalareasacrossCanada.Finally,theresultsoftheFNBIarestatisticallycomparedtotheCanadianHealthMeasuresSurvey(CHMS),ahealthsurveyofthegeneralCanadianpopulation.ComparisonswithCHMSresults,however,oughttobeinterpretedwithcautionasitstargeturbanpopulationslightlydiffersfromtheFirstNationpopulation,sinceFirstNationcommunitiesaremostlylocatedinisolatedorruralareas.

InthevastmajorityofFNBIresults,therearenosignificantdifferencesbetweenthebloodorurinelevelsoftracemetalsandotherchemicalsbetweentheFNBIandCHMSpopula-tions.Thereareafewexceptions,however.CotininelevelsaresignificantlyhigherinFirstNationparticipantsthanthoseshowninCHMS,whichislikelytheresultofahigherpercent-ageofsmokersandsecondhandsmokeexposureinFirstNations.ThequestionnairesrevealthattherateofFirstNationsmokersis65%,almostfourtimeshigherthantheCanadianpopulation.ThisisalsothelikelycontributortothefindingofsignificantlyhighercadmiuminFirstNations,althoughthiswasnotspecificallyexplored.

AnumberofchemicalswerefoundtobelowerintheFirstNationpopulation.Forinstance,bloodleadconcentrationswerestatisticallylowercomparedtolevelsofthegeneralCanadianpopulation.Severalorganiccompoundssuchastrans-nonachlor,beta-hexachlorocyclohexane(b-HCH),anddimethylphosphate(DMP)areallstatisticallylowerintheFirstNationpopulation,ascomparedtotheCHMSpopulation.

Theresultsformercuryposecertainambiguitiesthatwillre-quirefurtherinvestigation.Totalmercurybloodconcentrationsgavealargerangeofresults,wherethecoefficientofvariationwashigh.Thus,directstatisticalcomparisonwiththeCanadianpopulationwasnotpossible.However,astatisticalcomparisonperformedonacommunitybasiswaspossibleinsixofthe

thirteenFirstNationcommunities.Inthiscase,thesixFirstNationcommunitieshadstatisticallyhigherlevelsthantheCanadianpopulation.Oneinterestingfindingwaswithrespecttoinorganicmercuryfoundintheurinarysamples.StatisticalcomparisonsbetweenFNBIandCHMSsampleswerenotpossibleduetothefactthatmeanswerenotcalculatedfortheCHMSsamplesinceover40%ofthesamplewasbelowthelimitofdetection(LOD).TheFNBIestimateswerecalculatedbecauselessthan40%wasbelowtheLOD.ThisfindingledtheauthorstobelievethattheremaybeagreaterexposuretoinorganicmercuryintheFNBIpopulationthantheCHMSpopulation,butitrequiresfurtherinvestigation.

Anotherinterestingfindingrelatestothedifferenceinthenationaldataascomparedtotheecozonedata.Inthenationalleveldata,arseniclevelsweresignificantlylowerintheFNBIsample.However,whenobservingthearsenicbloodlevelsattheecozonelevelbyagedistribution,thePacificregiontotaland20-39yeargroupshavesignificantlyhigherlevelsthanthoseofthesameCHMSgroups.Thesamecanbeobservedintheecozonedatabygenderforurinaryarsenic(creatinineadjusted)forthe20-39agegroup.Thiswouldbeausefulareaforfurtherstudy.

TheFNBIhasbeenavaluabletoolinaddressingthegapsinknowledgeaboutthelevelsofenvironmentalchemicalsintheFirstNationpopulation.Itshouldbenotedthatthisisthefirststudyofthistypetobedoneonarepresentativecross-countryscale.Thedatacollectedwillserveasabenchmarkforfuturestudiestodetermineifchangesintheenvironmentareresultinginanincreaseordecreaseinconcentrationsofchemicalsofconcerns.TheFNBIprovidesausefulbaselineforsubsequentlongitudinalstudiesaswellasforthestudyofspecifichotspotsorareasofconcern.


c h a p t e r t h r e eintroduction to biomonitoring

Everyday,peopleareexposedtothousandsofchemicals-throughtheair,food,drinkingwater,andthingsthatcomeintocontactwithourskin.ItiswidelyassumedthatFirstNationpeoples’livinginremoteareasareatahigherriskofexposurethanthegeneralpopulationbecauseoftheirclosertiestotheland.Forexample,whilerelianceontraditionalfoodssuchasfish,marineanimalsandwildgamehascultural,spiritual,andnutritionalsignificance,thesefoodsourcesalsotendtohavehigherconcentrationsofmercuryandpersistentorganicpol-lutants(POPs).Thesechemicalsbuildupinthefattytissuesoffish,marinemammalsandotherfoodsourcesthroughtheprocessofbioaccumulationwhichcanthenbioaccumulateinpeopleconsumingit.

Biomonitoringhasbecomeanessentialtoolineffortstoidentifyandcontrolpeoples’exposuretoenvironmentalchemicals.Humanbiomonitoringisthemeasurementinpeople,ofachemical,theproductsitmakesafterithasbrokendown,ortheproductsthatmightresultfrominteractionsinthebody.Thesemeasurementsareusuallymadeinbloodandurineandsome-timesinothertissuesandfluidssuchashair,nails,andbreastmilk.Themeasurementstakenindicatehowmuchofachemicaloritselementsarepresentinthatpersonatagiventime.

National-levelbiomonitoringinitiativesincludetheEuropeanUnion-wideCOPHES(ConsortiumtoPerformHuman

BiomonitoringonaEuropeanScale)-currentlyinadem-onstrationphasecalledDEMOCOPHES,theUnitedStatesCenterforDiseaseControlNHANES(NationalHealthandNutritionExaminationStudy),andtheAustralianBureauofStatistics’NHS(NationalHealthSurvey).Canadahasjoinedtheranksofnationalbiomonitoringinitiativeswiththeongo-ingCanadianHealthMeasuresSurvey(CHMS).theranksofnationalbiomonitoringinitiativeswiththeongoingCanadianHealthMeasuresSurvey(CHMS).WhiletheCHMSisintendedtorepresenttheCanadianpopulation,itdoesnotincludeFirstNationpeopleslivingonreserve.

Assuch,thereisnorepresentativebaselineinformationontheextentofhumanexposure/bodyburdenofFirstNationpeoples’onreserveinregardtopersistentorganicpollutantsandheavymetals.ToaddressthisissueandtocomplementtheCHMS,theFNBIwasestablished.

TheFNBIreliesondatacollectedfromsamplesofadultmemberslivinginFirstNation(FN)communities.Allsamples–communities,householdsandindividuals–wereselectedusingrandommechanisms.Estimatingstatistics(e.g.,means,ratios,totals,percentiles)fromprobabilitysamplesrequiressomelevelofcareiftheestimatesaretoremainrepresentative(un-biased)ofthepopulationfromwhichthedatawerecollected.Moreover,sample-basedstatisticswillbepublishedalongwithanestimateoftheirsamplingerror.


background and rationale

c h a p t e r f o u r

Environmentalhealtheffortsbygovernments,researchers,andthoseinthehealthfieldhavebeensparkedbytheneedtoidentify,understandandwheneverpossible,reducepeo-ple’sexposuretopotentiallyharmfulenvironmentalchemicals.Biomonitoringisatoolthathasbecomecentraltotheseefforts.

TheCHMSisanationalsurveythatisbeingledbyStatisticsCanadainpartnershipwithHealthCanadaandthePublicHealthAgencyofCanadathatthemostcomprehensive,directhealthmeasuressurveyconductedinCanada.IthasbeendesignedtorepresenttheCanadianpopulationandcollectsinformationonthegeneralhealthandlifestyleofCanadiansthroughinterviewsanddirectphysicalmeasurements(i.e.weightandheight),toprovideinformationonchronicandinfectiousdiseases,physicalfitness,nutrition,andotherfactorsthatinfluencehealth1.TheCHMSalsoincludesabiomonitoringcomponent,wherebloodandurinesamplesarecollectedtoprovideinformationonexpo-suretoenvironmentalchemicals.

WhiletheCHMSisintendedtorepresenttheCanadianpopulation,itdoesnotincludeFirstNationpeopleslivingonreserves.Assuch,thereisnorepresentativebaselineinforma-tionontheextentofhumanexposure/bodyburdenofFirstNationpeoplesonreserveinregardtochemicals(includingpersistentorganicpollutants,tracemetals,etc.).

TheFNBIseekstoaddressthisinformationgap.TheAssemblyofFirstNations(AFN),inpartnershipwithHealthCanada(throughtheFirstNations&InuitHealthBranch-FNIHB),carriedoutahumanbiomonitoringprogramwhichincludedahouseholdquestionnaire,directphysicalmeasure-ments(i.e.heightandweight),andthecollectionofbloodandurinesamplestoprovidebaselineinformationofFirstNationpeoples’exposurelevelstoenvironmentalchemicals.Thisini-tiativewasimplementedthroughleadershipandpartnershipwithFirstNationsauthoritiesandwasadaptedforculturalappropriatenessandsafetythroughconsultationswiththeFirstNationcommunities.

TheFNBIisa5-year(2008-2013)nationalhealthsurvey,exclusivelyforFirstNationpeoples’livingonreserve,southof60o.TheAFNcarriedoutthisInitiativeandFNIHBservedasfunderandtechnicaladvisor.

TheFNBI’smainobjectiveistoestablishanationalbaselineofFirstNations’exposureto97environmentalchemicals(persistentorganicpollutants,tracemetals,andahostofotherchemicals).OtherobjectivesoftheFNBIareto:

• Allowindividuals,theirfamiliesandFirstNationcommunitiestobecomemoreawareofandtakestepstominimizetheirexposuretoenvironmentalchemicals;

• AllowforcomparisonbetweenFirstNations’exposuretoenvironmentalchemicalsandthoseoftheCanadianpopulation,whicharebeingmeasuredundertheCHMS;

• Overtime,tracktrendsofexposurelevelsinFirstNationspopulations,identifyprioritychemicals,andguidefurtheractionbyindividuals,communitiesandgovernment(s);

• Collectinformationthatcannototherwisebegatheredfromquestionnairesalone;

• Exploreemergingenvironmentalpublichealthissuesandnewmeasurementtechnologies.

1.HealthCanada,“ReportonHumanBiomonitoringofEnvironmentalChemicalsinCanada.ResultsoftheCanadianHealthMeasuresSurveyCycle1(2007-2009),2010.(CHMSReport)Retrievedfromwww.healthcanada.gc.ca


4.1 First nation ownership of data:

TheFirstNationsBiomonitoringInitiative(FNBI)wasdesignedtoberespectfultotheFirstNationsprinciplesofOwnership,Control,AccessandPossession(OCAP)2:

Ownershipwherebycommunitiesowninformationcollectively,thesamewayasanindividualownstheirpersonalinformation;Controlofallaspectsofresearchandinformationmanagement,thatimpactFirstNations,fromconceptiontocompletion;AccesstoFirstNationsinformationanddata,regardlessofwhereitisstored;and,Possessionofthedatasothatownershipcanbeprotected.Ifdataisownedbyapartybutisinpossessionofanother,thereisriskofbreach;

ThisapproachensuresthatFirstNationcommunities,whoaretheparticipants,makethedecisionsabouttheprocess,thedatacollectionandanalysis,anddecision-making.

TheAFNactsascustodianfortheresultingbiomonitoringdata,whiletheFirstNationcommunitiesthatparticipatedinthestudywouldowntheirowndataandcontrolthefutureuse,disseminationortransferofdata.ThebenefitsofOCAParemultiple;someofthemareexplainedasfollows:

• Helpsrebuildcommunitytrustinresearch;

• Higherparticipationrates;

• Encouragesmoreholistic(FN)approachtohealth;

• PromotesFirstNationsanalysesandperspectivesthatminimizesbiasesandmisinterpretations;and

• Contributestocommunityempowerment,self-determination,andhealingactivitiesandencouragesmeaningfulcapacitydevelopment.

2.FirstNationsInformationGovernanceCentre(2010).The First Nations Principles of OCAP: What is OCAP?Retrievedfromhttp://www.fnigc.ca/node/2.


survey designc h a p t e r f i v e

5.1 Pilot study

ApilotstudywascarriedouttodeterminethefeasibilityofimplementingthefullscaleFNBIhealthsurveyandrevealanychallengesinthesampledesign.ThepilotstudyallowedtheFNBIteamtotestlogisticsandgatherinformationoninterac-tionswithFirstNationcommunitiesandparticipants.Thepilotstudywascarriedoutwiththeaimofmodifyingareasofcon-cern,asanyrevealeddeficienciesinthedesignorprocedurescouldbecorrectedbeforetimeandresourceswereexpendedforthefullsurvey.Thepilotstudyledtomanyobservationsandlessonslearned,particularlyintheareasof:logisticsandoperationalprocedures;amountoftimetoconductallaspectsofthesurvey;gaugingFirstNationinterestandparticipation;appropriatenessofthecommunicationsplantoparticipantsandthecommunity;andhumanandfinancialresources.FurtherdetailsonthepilotstudycanbefoundinAppendix1.

5.2 target Population and selection criteria

Forthepurposeofthisstudy,participantswererandomlyselectedamongtheFNBItargetpopulationwhichincludespeoplelivingonreserveaged20yearsorolder.Participantswereretainedforthestudyonlyiftheywereabletoprovidewritteninformedconsent.However,participantswereex-cludediftheywerepregnantoriftheyhadrecentlyundergonechemotherapy,astherewouldnothavebeenenoughoftheseparticipantstodetermineiftheirexposuresweresignificantlydifferentthantherestofthecommunity.

5.3 methodology

TheFNBIfollowedanecozoneapproachsincethesegeograph-icareaswereestablishedaccordingtoecosystemboundarieswithsimilarvegetationandwildlife,whichconformstotradi-tionalFirstNationslanduse.Aminimumof2communitiesperecozonewerechosenbyrandomselectionand,similarly,42participantswererandomlyselectedwithineachcommunity.RefertoAppendix2fortheecozones&sampleallocationandAppendix10&11forFNBImethodology.

5.4 limitations

Aswithotherbiomonitoringstudies,theFNBIencounteredanumberoflimitations.Tobegin,thenumberofcommunitymemberscontainedinFirstNationbandlistswasnotretainedtobeusedintheanalysisduetoprivacyconcernsandattherequestofFirstNationgovernments.Itssignificanceisex-plainedinthesurveydesignsection.

ThelimitedbudgetofthestudyalsoposedsomelimitationsfortheInitiative,whichmeantthatthesamplesizeinboththenumberofcommunitiesandthenumberofparticipantsineachhadtobereduced.Thisresourcelimitationisalsothereasonwhythestudyexcludedpersons19yearsofageandunder,aswellaspregnantwomen.Ontheanalysisside,thesmallsampletranslatedtotheimpossibilityofprovidingananalysisusingbothgenderandagegroups;thus,thedecisionwasmadetoprovidetheresultsbygenderonly.Secondly,theanalysisresolutionpowerwaslimitedtoonlyprovidingana-tionallevelviewandcommunitylevelunderstanding,withoutecozonelevelanalysis.Andfinally,giventhehighcoefficientofvariationintheresults,theFNBIreportisbasedonthegeometricmean(G.M)andnotthe95thpercentile.

5.5 Fieldwork and laboratory analysis

FieldworktookplaceintheselectedFirstNationcom-munities,andincludedthefollowingcomponents:physicalmeasurements,ahouseholdquestionnaire,andbiospecimencollection.CommunityResearchAssistants(CRAs)wereresponsibleforadministeringthehouseholdquestionnairetoparticipants,whichcouldbecompletedattheparticipant’shomeoratthehealthfacilityandintheirownlanguage.PhysicalmeasurementsandbiospecimensamplecollectionwereperformedbyaRegisteredNurse.Measurementsandsamplecollectionweretakenatthehealthfacilityonreserveaccordingtostandardhealthcareprotocols.Theparticipantwasaskedaseriesofscreeningquestionspriortothestartoftheclinicprocesstoensurethatheorshewaseligibleforthetests,sincesomemedicationsandphysicalconditionsmayexcludeapersonfromthestudy.Physicalmeasurementsin-cludedheight,weight,skinfold,circumferences,restingheartrateandbloodpressure(Appendix4).Thenursecollected


20milliliters(mL)ofbloodandaminimumof20mLofurinefromparticipants(Appendix5).Theprojectcoordinatorwasresponsiblefortemporarilystoringthesamplesinfreezersat-20oC,andshippedthesetotheaccreditedlaboratory.ShipmentswerepackagedaccordingtotheInternationalAirTransportAssociation(IATA)andTransportofDangerousGoods(TDG)Regulations.

Laboratoryanalysisof97environmentalchemicalsandcreati-ninewasperformedattheCentredetoxicologyduQuébec(CTQ)ofL’InstitutnationaldesantépubliqueduQuébec(INSPQ),QuébecCity.AnalyseswereconductedaccordingtoacceptedmethodsandatthesameCanadianAssociationforLaboratoryAccredited(CALA)certifiedlaboratoryusedintheCHMSstudytoensuremaximumcomparabilityofresults.TheINSPQisaccreditedunderISO1725andfollowedstandard-izedoperatingprocedures.

DescriptionsoftheanalyticalmethodsusedintheFNBIhavebeenpreviouslypublishedbytheCanadianHealthMeasuresSurvey(HealthCanada,20103).

5.6 data collection

Uponsigningtheconsentform,whichincludedthepar-ticipant’snameandcontactinformationforthepurposeofcommunicatingresultsofanalysis,participantswereassignedanumberandassociatedbarcode.Allotherdocumentationwaslabeledwiththebarcodeonly,ratherthantheparticipants’nameorotheridentifyinginformation,toensureprotectionoftheparticipants’privacy.

Thestepsthataparticipantwasaskedtocompleteincluded:signingtheconsentform(refertoAppendix8);complet-ingthequestionnaire(administeredbytheCRA)(refertoAppendix3);submittingtoasuiteofphysicalmeasurements(i.e.height,weight,bloodpressure,bodymassindex(BMI),skinfold,waist-to-hipratio);andprovidingbiospecimensam-ples(bloodandurine)forchemicalanalysis.Physicalmeasure-mentsandbiospecimensamplecollectionwereperformedbetweenJulyandOctober,2011byacontractedRegisteredNursefromanagency.

CommunityResearchAssistants(CRAs)wereneededtoassistinconductingthequestionnaires.ThedecisiontohirelocalpeopleasCRAsservedseveralpurposes;havingalocal,familiarfaceconducttheinterviewsandserveasinterpreters/transla-torsasneeded;initiatecontactwiththerandomlyselectedparticipants;scheduleappointments;organizethecommunityandfacilitiesforthearrivalofthefieldteam;contributetothe

capacitybuildingatthelocallevel;and,providetemporarylocalemployment.Thosewithpriorresearchstudyexperienceandappropriateeducation,weresought,inconsultationwiththeCommunityHealthDirectors,andhiredforthedurationofFNBIsampling-normallyoneweek.

5.7 reporting results to Participants:

Thedecisionwasmadethatparticipantsshouldhavetherighttotheirownpersonalresults.Assuch,allresultswerere-turnedtoparticipantsafteranalysis,unlesstheyhadexpressedthedesirenottoreceivethemduringsampling.Aswell,earlynotificationwasdoneincaseswhereaparticipant’sresultsexceededtheCanadianbloodleadinterventionlevelof10μg/dL(setbytheCEOHin1994)orthe1994HealthCanadabloodmercuryguidanceforadultsof20μg/L(sincetheyaretheonlyacceptedguidelinelevelsinblood,todate).Cadmiumwasalsoreportedtoparticipantsiftheyexceededtheoccu-pationalguidelineforbloodcadmiumof5μg/L(INSPQ,2008).Oncephysicalmeasurementsweretaken(e.g.bloodpressure,heartrate,bodymeasurements),participantswereimmediatelyprovidedwiththeirwrittenresultsfromthenurse.

Inadditiontoprovidingeachindividualparticipantwiththeirresults,theAFNprovidedcommunityreportstoeachpar-ticipatingFirstNationandincludedtheircompletedataset.Whererequested,theFNBIteamreturnedtotheparticipatingFirstNationcommunitytomakeaformalpresentationoftheresultsfromtheStudytotheleadership,healthofficialsandcommunityatlarge.TheAFNalsoprovidedsubsequentreportsoverteleconferencestocommunityofficials.Theparticipat-ingFirstNationcommunitiesexpressedsinceregratitudeforAFN'seffortstoreportfindingsbacktothecommunity.

5.8 considerations for interpreting the biomonitoring data4:

ComparisonswithCHMSresultsshouldbeinterpretedwithcautionasitstargetpopulationslightlydiffersfromtheFNBItargetpopulation.CHMSwasconductedinageographicareawithapopulationofatleast10,000andamaximumrespond-enttraveldistanceof100kilometers.ThisdiffersfromtheFirstNationrealitywherecommunitiesvaryinsizeandpopulationandaremostlylocatedinisolatedorruralareas.

TheFNBIwasdesignedtoprovideestimatesofenvironmentalchemicalconcentrationsinbloodorurinefortheadultFirstNationpopulationasawhole.Thesurveywasnotdesigned

3.HealthCanada(2010).ReportonHumanBiomonitoringofEnvironmentalChemicalsinCanada.ResultsoftheCanadianHealthMeasuresSurveyCycle1(2007-2009).(CHMSReport)Retrievedfromwww.healthcanada.gc.ca

4.TakenfromHealthCanada(2010).ReportonHumanBiomonitoringofEnvironmentalChemicalsinCanada.ResultsoftheCanadianHealthMeasuresSurveyCycle1(2007-2009).(CHMSReport)Retrievedfromwww.healthcanada.gc.ca

20 national results

tocovertheentirepopulation,norwasitdesignedtopermitfurtherbreakdownofdatabycommunity.Inaddition,theFNBIdesigndidnottargetspecificexposurescenariosandconsequently,didnotselectorexcludeeithercommunitiesorrespondentsonthebasisoftheirpotentialforloworhighexposurestoenvironmentalchemicals.

Biomonitoringcanestimatehowmuchofachemicalispresentinaperson,butcannottellyouwhathealtheffects,ifany,mayresultfromthatexposure.Technologyinthemeasurementofchemicalsatverylowlevelshasadvancedeventhoughthepresenceofachemicalinaperson’sbodydoesnotnecessarilymeanthatitwillcauseahealtheffect.Severalfactorssuchastheamount,theduration,frequencyandtimingofexposureandthetoxicityofthechemicalareimportantinordertodeterminewhetheradversehealtheffectsmayoccur.Forchemicalssuchasleadormercury,researchstudieshaveprovideduswithagoodunderstandingofwhathealthrisksareassociatedwithdifferentlevelsinblood.However,formanychemicals,furtherresearchisneededtounderstandthehealtheffects,ifany,fromdiffer-entbloodorurineconcentrations.Furthermore,smalldosesofcertainchemicalsareessentialforthemaintenanceofgoodhealth(e.g.manganeseandzinc)sosmallamountswouldbeexpectedtobepresentinthebody.Inaddition,chemicalswillinteractdifferentlydependingontheindividual.Certainpopula-tions(children,pregnantwomen,andtheelderlyorimmuno-compromisedpeople)maybemoresusceptibletotheeffectsofchemicalexposure.

Theabsenceofachemicaldoesnotnecessarilymeanapersonhasnotbeenexposed.Itmaybethatthetechnologyisnotca-pableofmeasuringsuchasmallamount,orthattheexposureoccurredatanearlierpointintime,allowingforthechemicaltobeeliminatedfromtheperson’sbodybeforemeasurementtookplace.Biomonitoringcannottellusthesourceorrouteoftheexposurebutitindicatesthetotalamountthatisinthebodyatagiventime,andaccountsforallroutesofexposure(ingestion,inhalation,skincontact)andfromallsources(air,water,soil,food,andconsumerproducts).

Manychemicals–lead,mercury,cadmium,andarsenicforexample–occurnaturallyintheenvironmentandarealsopresentinhuman-madeproducts.Withtheexceptionofmet-als,mostoftheurinemeasurementsinthissurveyquantifychemicalmetabolites.Formanychemicals,parentcompoundsmaybebrokendown(i.e.,metabolized)intooneormoremetabolites.Somemetabolitesarespecifictooneparentcompound,whileothersarecommontoseveralparentcom-pounds.Severalurinarymetabolitesarealsoenvironmentalmetabolites(e.g.,dialkylphosphatemetabolites)andtheir

presenceinurinedoesnotnecessarilymeanthatanexposuretotheparentchemicalhasoccurred;ratherexposurecouldbetothemetaboliteitselfinenvironmentalmediasuchasfood,water,orair.Factorsthatcontributetomeasuredbloodandurinelevelsincludethequantityenteringthebodythroughallroutesofexposure,absorptionrates,distributiontovarioustissuesinthebody,metabolism,andexcretionofthechemi-caland/oritsmetabolitesfromthebody.Theseprocessesaredependentonboththecharacteristicsofthechemical,includ-inglipophilicity,pH,andparticlesize,andthecharacteristicsoftheindividual,suchasage,diet,healthstatus,andrace5(Teassetal.,2003).Forthesereasons,thewayinwhichachemicalwillactinthebodywilldifferamongindividualsandcannotbepredictedwithcertainty.

Thisreportdoesnotexaminetrendsovertimeasthisisthefirstsurveyofits’kind,specifictoFirstNations.ResultsfromfuturecyclesofFNBI,orsimilarstudies,maybecomparedtothebaselinedatainordertoexaminetrendsinFirstNations’exposurestoselectedenvironmentalchemicals.

5.9 data analysis

DatatablesarepresentedforeachchemicalmeasuredundertheFNBI.Thesetablesinclude:samplesize(n),percentageofresultsthatfallbelowthelimitofdetection(%


kglipid).Inordertoreflecttheamountofthesechemicalsthatarestoredinbodyfat,theconcentrationsofthesechemicalsarereportedrelativetolipids(HealthCanada,2010)6.

Forchemicalsmeasuredinurine,concentrationsarepresentedasweightofchemicalpervolumeofurine(μgchemical/Lurine)andadjustedforurinarycreatinine(μgchemical/gcre-atinine).Urinarycreatinineisachemicalby-productgeneratedfrommusclemetabolismandisfrequentlyusedtoadjustforurineconcentration(ordilution)inspoturinesamplesbecauseitsproductionandexcretionarerelativelyconstantover24hoursduetohomeostaticcontrols.Ifthechemicalmeasuredbehavessimilarlytocreatinineinthekidney,itwillbefilteredatthesamerate.Thisexplainswhyexpressingthechemicalpergramofcreatininehelpscorrectfortheeffectofurinarydilutionaswellassomedifferencesinrenalfunctionandleanbodymass(RefertoHealthCanada’sReportonHumanBiomonitoringofEnvironmentalChemicalsinCanada7).

Foranalyticalpurposes,theG.Mistakenintoaccountasanin-dicationofthetruecenterofthedistributionofresults.Thesechemicalsarefoundinthehumanbodyinverysmallquanti-tiesproducingaskeweddistributionwithverysmallvalues(


c h a p t e r s i xethical considerations

Participationwasrandomforthisstudyandtheparticipantwasfreetowithdrawfromthestudyatanypointintimedur-ingtheprocess.Participantswereinformedoftheirrighttowithdrawbothverballyandinwriting.Priortoparticipating,volunteerswereprovidedwithfactsheets,andastep-by-steppamphletexplainingtheprocess.Iftheindividualwasinterest-edinparticipating,theysignedaconsentformtoconfirmtheirfreeandinformedparticipation.

EachparticipantwasassignedanumericIDnumber.Alllabora-toryanalysisanddatamanagementdonebyeitherthelabora-tory,HCandStatisticsCanadawereconductedusingtheIDs.Therefore,noresultscouldbetracedbacktoanyindividualparticipant.ThecommunityquestionnaireswerealsocollectedusingthenumericIDnumbers.Furthermore,alldatabelongstothecommunityandanyfurtheruseofitbeyondthedevel-opmentoftheindividualcommunityreportsandthenationalreport,wouldneedtobeaccessedandauthorizedbythecom-munitiesthemselves.

Thelaboratorythatconductedtheanalysisofblood/urinesignedaconfidentialitycontractwiththeAFNtoensurethatthesampleswouldbeproperlydestroyedafterbeingprocessedandthattheywouldnotbestoredforanyotherresearch(i.e.nobio-banking).

Allinformationregardingsampling,questionnaire,andconsentformsiskeptanonymouslyinadatabaseattheAFN,groupedbyregions,andaccessiblebytheAFN-FNBIteam.Datawillonlybemadeavailableifpresentedinawaythatdoesnotpermitindividualorcommunityidentification,unlessotherwiseagreedbytheparticipants’permission.

EthicsapprovalforallcomponentsoftheFNBIwasobtainedfromtheHealthCanada’sResearchEthicsBoard.Aswell,approvalfortheFNBIwasobtainedthroughanAssemblyofFirstNationsallchiefsresolution.EthicalconsiderationswerealsoaddressedthroughtheestablishmentofaFirstNations’PlanningandAdvisoryCommittee,developmentofindividualBandCouncilresolutionsandseparatecommunityresearchagreementswitheachinterestedcommunity,anddevelopmentofindividualconsentforms.


AnexpertworkshopwashostedbyHealthCanadain2003toprovidethebasisfortheCHMSCycle1chemicalselec-tion.Substanceswereselectedfromapreviouscandidatelistofover200individualchemicalcontaminantsorgroups.Thosethatwereselectedwerebasedonanumberofconsiderationsincluding:knownorsuspectedhealthrisks,levelofpubliccon-cern,evidenceofexposureintheCanadianpopulation,coststoperformthetest,andneworexistingrequirementsforpublichealthaction,etc.BasedonresultsfromquestionnairesthatweresenttoallFirstNationcommunitiesandtheadviceoftheFirstNationsPlanningandAdvisoryCommitteefortheFNBI,theCHMSCycle1suiteofchemicalswasselectedforinclusionintheFNBItoallowforcomparisonsbetweentheCanadianandFirstNationpopulations.Thesearelistedinthefollowingtable:

ChemicalGroup NumberofSubstances Matrix

TraceMetals (13)antimony,arsenic,cadmium,copper,lead,manganese,mer-cury,molybdenum,nickel,selenium,uranium,vanadium,zinc bloodandurine

Polychlorinatedbiphenyls(PCBs) 24substancesandaroclor1260 plasma

Polybrominateddiphenylethers(PBDEs) 10congeners plasma

Organochlorinepesticides 14substances plasma

Perfluorinatedcompounds(PFCs) 9substances plasma

Environmentalphenol(BPA) 1substance urine

Phthalates 11metabolites urine

PesticidesOrganophosphatemetabolites(6),

phenoxyherbicides(2),pyrethroidpesticides(5)urine

Tobacco(cotinine) 1metabolite urine

chemicals measuredc h a p t e r s e v e n

8.HealthCanada(2010).ReportonHumanBiomonitoringofEnvironmentalChemicalsinCanada.ResultsoftheCanadianHealthMeasuresSurveyCycle1(2007-2009).(CHMSReport)Retrievedfromwww.healthcanada.gc.ca

PleaserefertoAppendix6forthefulllistofchemicals.

Regardingperfluorinatedcompounds(PFCs)measuredinplasma,theFNBIsampled9PFCs,whileCHMSmeasured3,thuscomparisonswereonlymadewiththe3in-commonPFCs:PerfluorooctaneSulfonate(PFOS),PerfluorooctanoicAcid(PFOA),andPerfluorohexaneSulfonate(PFHxS).

InordertomaketheFNBIthemostcomparativepossibletoCHMS,themethodology,sampling,processingandlaboratory

analysistechniqueswerereplicated.Therefore,bloodandurineweretheonlybiologicalspecimenscollected,asdescribedinthesamplecollectionprocedure(Appendix5).

InformationaboutchemicalsinthisreporthasbeenadaptedfromHealthCanada’s(2010)“ReportonHumanBiomonitoringofEnvironmentalChemicalsinCanada.ResultsoftheCanadianHealthMeasuresSurveyCycle1(2007-2009)8.


8.1 antimony

Antimony(Sb)isanaturallyoccurringelementwhichisreleasedintotheenvironmentprimarilythroughindustrialprocessesbutcanalsobefoundintheenvironmentnaturallyduetonaturalweatheringofrocks,runofffromsoils,emissionsfromvolcaniceruptions,seaspray,andforestfires.Itisreleasedintotheairasstackdustfromindustrialsources,suchascoal-firedpowerplants,inorganicchemicalplants,andmetalsmelterswhileitmayentertheaquaticenvironmentbywayofeffluentsfrommin-ingandmanufacturingoperations,andthroughindustrialandmunicipalleachatedischarges(HealthCanada,1997).

Antimonyisusedinvarioussettings,mostfrequentlyintheproductionofsemi-conductors,infrareddetectors,anddiodes;itisusedasacomponentinalloysforbatteries,cablesheathing,plumbingsolder,ammunitionandfireworks,flameretardantandanti-frictionmaterials;andasanadditiveinpaintpigments,glass,andceramicproducts(HealthCanada,1997;NTP,2005;ATSDR,1992).

FoodingestionisthemainrouteofexposuretoCanadiansbuttheycanalsobeexposedtoantimonyfromwater,air,dust,ordirectdermalcontactwithconsumerproductscontainingantimony(EURAR,2008).Theamountofantimonypresentinthebodyisgenerallylowforthosenotexposedoccupationally.Antimonyismostcommonlymeasuredinbloodandurine,asitwasdonefortheFNBI,andthismeasurementisreflectiveofexposuretoantimonyandantimony-relatedcompounds(ATSDR,1992).Somestudieshaveestimatedaneliminationhalf-lifeofapproximately95hoursafteranoccupationalexpo-surehasoccurred,(Kentneretal.,1995).

8.1.1 FindingsAntimonywasmeasuredinurineoftheFNBIsampleandispresentedasμg/Lurineandμg/gcreatinine(Tables1.1–1.6).Urinaryantimonylevelscanprovidephysiciansandhealthofficialswithreferencerangesthatcanbeusedtodeterminewhetherpeoplehavebeenexposedtohigherlevelsofantimo-nythanarefoundinotherpopulations.Slightlyhighervaluesmaybeduetomethodologic,population,orexposurediffer-ences(CDC,2012).

MeasurablelevelsofurinaryantimonyfoundintheFNpopula-tionreflectrecentexposure.Findingameasurableamountofantimonydoesnotnecessarilymeanthatanadversehealtheffectwilloccur.

Levelsofurinaryantimonyreflectrecentexposure.Findingameasurableamountofantimonydoesnotnecessarilymeanthatanadversehealtheffectwilloccur.

UrinaryantimonylevelsobservedintheFNBIsampleweresimilar(i.e.notsignificantlydifferent)tolevelsobservedintheCHMSsample.

c h a p t e r e i g h tresults by chemical group metals and trace elements


table 1.1.

antimony - arithmetic and geometric means of urine concentrations (µg/l) for on-reserve and crown land population aged 20 years old and older, Fnbi 2011

Population Sex n %<LODA.M.95%CI

G.M.95%CI

10th95%CI

25th95%CI

50th95%CI

75th95%CI

90th95%CI

95th95%CI

ComparedtoCHMSG.M.

FNBITotal

Total 495 20.200.08E 0.05

26 national results

table 1.3

antimony - arithmetic and geometric means of urine concentrations (µg/l) for on-reserve and crown land population aged 20 years old and older, Fnbi 2011 – ecozone by age distributionFNBI

EcozoneAgegroup n

%<LOD

A.M.95%CI

G.M.95%CI

10th95%CI

25th95%CI

50th95%CI

75th95%CI

90th95%CI

95th95%CI

Total Total 495 20.20.08E 0.05


antimony - arithmetic and geometric means of urine concentrations (µg/l) for on-reserve and crown land population aged 20 years old and older, Fnbi 2011 – ecozone by age distributionFNBI

EcozoneAgegroup n

%<LOD

A.M.95%CI

G.M.95%CI

10th95%CI

25th95%CI

50th95%CI

75th95%CI

90th95%CI

95th95%CI

Pacific 60-99 21 19.00.06 0.04

28 national results

antimony (creatinine adjusted) - arithmetic and geometric means of urine concentrations (µg/g) for on-reserve and crown land population aged 20 years old and older, Fnbi 2011 –ecozone by age distributionFNBI

EcozoneAgegroup n

%<LOD

A.M.95%CI

G.M.95%CI

10th95%CI

25th95%CI

50th95%CI

75th95%CI

90th95%CI

95th95%CI

Boreal 40-59 62 30.60.07E 0.05E


table 1.5

antimony - arithmetic and geometric means of urine concentrations (µg/l) for on-reserve and crown land population aged 20 years old and older, Fnbi 2011 –ecozone by gender distributionFNBI

Ecozone Sex n%<LOD

A.M.95%CI

G.M.95%CI

10th95%CI

25th95%CI

50th95%CI

75th95%CI

90th95%CI

95th95%CI

Total Total 495 20.20.08E 0.05

30 national results

table 1.6

antimony (creatinine adjusted) - arithmetic and geometric means of urine concentrations (µg/g) for on-reserve and crown land population aged 20 years old and older, Fnbi 2011 – ecozones by gender distributionFNBI

EcozoneSex n %<

LODA.M.95%CI

G.M.95%CI

10th95%CI

25th95%CI

50th95%CI

75th95%CI

90th95%CI

95th95%CI

Total Total 495 20.20.08E 0.06


8.1.2 referencesATSDR(AgencyofToxicSubstancesandDiseaseRegistry).(1992).ToxicologicalProfileforAntimony.Retrievedfromwww.atsdr.cdc.gov/toxprofiles/tp23.html

CentersforDiseaseControlandPrevention(CDC).Fourth National Report on Human Exposure to Environmental Chemicals. Updated Tables,2012.[online]AvailableatURL:http://www.cdc.gov/exposurereport/.10/1512

CentersforDiseaseControlandPrevention(CDC).NationalBiomonitoringProgram.BiomonitoringsummaryforAntimony(2012).[online]AvailableatURL:http://www.cdc.gov/biomoni-toring/biomonitoring_summaries.html

EURAR(EuropeanUnionRiskAssessmentReport).(2008).Draft:CAS:1309-64-4:DiantimonyTrioxide.Luxembourg:OfficeforOfficialPublicationsoftheEuropeanCommunities.Retrievedfromwww.ecb.jrc.ec.europa.eu/risk-assessment/

HealthCanada.(1997).GuidelinesforCanadianDrinkingWaterQuality–SupportingDocument:Antimony.WaterQualityandHealthBureau,SafeEnvironmentsProgramme.Retrievedfromwww.hc-sc.gc.ca/ewh-semt/pubs/water-eau/antimony-antimoine/index-eng.php

HealthCanada(2010).ReportonHumanBiomonitoringofEnvironmentalChemicalsinCanada.ResultsoftheCanadianHealthMeasuresSurveyCycle1(2007-2009).Retrievedfromwww.healthcanada.gc.ca

KentnerM.,LeinemannM.,Schaller,K.H.,Weltle,D.,&Lenert,G.(1995).Externalandinternalantimonyexposureinstarterbatteryproduction.InternationalArchivesofOccupationalandEnvironmentalHealth67,119–23.

NTP(NationalToxicologyProgram).(2005).AntimonyTrioxide:BriefToxicologicalSummary.Retrievedfromwww.ntp.niehs.nih.gov/?objectid=7F90D949-F1F6-975E-7C681F79F29176F6#antimtriox

WHO(WorldHealthOrganization).(2003).AntimonyinDrinking-water.Retrievedfromwww.who.int/water_sanita-tion_health/dwq/chemicals/0304_74/en/index.html

32 national results

8.2 arsenic

Arsenic(As)isanaturallyoccurringelementwhichmayenterlakes,rivers,orgroundwaternaturally,whenmineraldepos-itsorrockscontainingarsenicdissolves.Theprimaryhumansourcesofarsenicreleasedtotheenvironmentarethesmelt-ingofmetalores(mainlygoldinCanada),theuseofarsenicalpesticides,andtheburningoffossilfuels(HC,2006).

Arsenicwasusedinthepastbyapplyingleadarsenateasapesticideinappleorchardsandvineyards,andarsenictri-oxideasanherbicide(HealthCanada,2006;ATSDR,2007).Chromatedcopperarsenateisusedonlyforindustrialpurpos-esandfordomesticwoodfoundationsbutwasformerlyusedasawoodpreservativeinresidentialconstructionprojectssuchasplaygroundstructuresanddecks(PMRA,2005).Nowadays,itisusedinthemanufactureoftransistors,lasers,andsemi-conductors,andintheprocessingofglass,pigments,textiles,paper,metaladhesives,ceramics,woodpreservatives,ammunition,andexplosives.

Themainsourceofarsenicintakeisthroughfood,mainlymeatandfish.Otherroutesofexposureincludedrinkingwater,soil,andambientair(EnvironmentCanada&HealthCanada,1993).Peoplelivinginthesurroundingareasofindustrialandgeologicalsourcesmaybemoreexposedtoarsenic,usuallythroughdrinkingwater.Higherlevelsofarseniccanbefoundingroundwaterthaninsurfacewater,whereitcanalsobefound.Somestudieshaveshownthatsmokersarealsoexposedtoarsenicincigarettes,althoughitisconsideredtobeofminorimportanceforarsenicabsorption(Schneider&Krivan,1993).

8.2.1 FindingsArsenicwasmeasuredinbloodandurineoftheFNBIsampleandispresentedasμg/Lblood,μg/Lurineandμg/gcreatinine(Tables2.1–2.9).Arseniclevelscanprovidephysiciansandhealthofficialswithreferencerangesthatcanbeusedtode-terminewhetherpeoplehavebeenexposedtohigherlevelsofarsenicthanarefoundinotherpopulations.

Levelsofbloodandurinaryarsenicreflectrecentexposure.Findingameasurableamountofarsenicdoesnotnecessarilymeanthatanadversehealtheffectwilloccur.

BloodandurinaryarseniclevelsobservedintheFNBIsampleweresignificantlylowerthanlevelsobservedintheCHMSsample.

Forbloodarsenic,whenobservingecozonetablesbyagedistribution(Table2.2),thePacificregiontotaland20-39yeargroupshavehigherlevelsthanthoseofthesameCHMSgroups.Thesamecanbeobservedintheecozonetablebygen-der(Table2.3)forurinaryarsenic(creatinineadjusted)forthe20-39agegroup.


table 2.1.

arsenic - arithmetic and geometric means of blood concentrations (µg/l) for on-reserve and crown land population aged 20 years old and older, Fnbi 2011


G.M.95%CI

10th95%CI

25th95%CI

50th95%CI

75th95%CI

90th95%CI

95th95%CI

ComparedtoCHMSG.M.

FNBITotal

Total 473 15.600.84 0.49

34 national results

arsenic - arithmetic and geometric means of blood concentrations (µg/l) for on-reserve and crown land population aged 20 years old and older, Fnbi 2011 – ecozones by age distributionFNBI

EcozoneAgegroup n

%<LOD

A.M.95%CI

G.M.95%CI

10th95%CI

25th95%CI

50th95%CI

75th95%CI

90th95%CI

95th95%CI

Boreal Total 52 30.30.48E 0.37E


table 2.3.

arsenic - arithmetic and geometric means of blood concentrations (µg/l) for on-reserve and crown land population aged 20 years old and older, Fnbi 2011 – ecozones by gender distributionFNBI

Ecozone Sex n%<LOD

A.M.95%CI

G.M.95%CI

10th95%CI

25th95%CI

50th95%CI

75th95%CI

90th95%CI

95th95%CI

Total Total 473 15.60.84 0.49

36 national results

table 2.4.

arsenic - arithmetic and geometric means of urine concentrations (µg/l) for on-reserve and crown land population aged 20 years old and older, Fnbi 2011


G.M.95%CI

10th95%CI

25th95%CI

50th95%CI

75th95%CI

90th95%CI

95th95%CI

ComparedtoCHMSG.M.

FNBITotal

Total 495 8.1011.63 4.47 F 2.21E 4.29 7.98 20.96 39.12

↓10.10-13.16 3.40-5.89 F 1.22-3.20 3.49-5.09 6.77-9.18 16.94-24.98 30.89-47.34

F 302 8.9010.90 4.22 F 1.93E 4.04 7.90 20.78 42.47E

↓8.43-13.37 3.28-5.44 F 1.10-2.77 3.25-4.83 5.40-10.40 16.02-25.54 28.01-56.93

M 193 6.7012.35 4.73 F 2.66E 4.38 8.03 20.47 38.38E

↓10.15-14.54 3.42-6.54 F 1.65-3.68 2.99-5.78 6.96-9.09 14.59-26.36 22.98-53.78

CHMS

Total 3474 0.1723.29 12.07 3.19 5.84 11.84 24.32 44.88 70.83

17.98-28.59 10.11-14.4 2.9-3.48 5-6.69 9.3-14.37 18.84-29.79 37.6-52.16 51.03-90.63

F 1842 0.1621.44 10.66 2.79 5.01 10.65 21.88 41.45 67.88

16.47-26.4 9.06-12.54 2.34-3.24 4.24-5.79 8.64-12.66 18.11-25.64 33.6-49.29 47.31-88.46

M 1632 0.1825.18 13.69 3.78 7.02 13.26 27.5 47.38 73.49

18.71-31.65 11.24-16.69 3.37-4.19 5.71-8.34 9.8-16.72 20.51-34.49 37.06-57.71 50.98-96

Note:If>40%ofsampleswerebelowLOD,thepercentiledistributionisreportedbutmeanswerenotcalculatedEmeansthatthesurveyestimatesshouldbeusedwithcaution.Theirassociatedcoefficientofvariationarebetween16.6%and33.3%Fmeansthatthesurveyestimatesweretoounreliabletobepublished.Theirassociatedcoefficientofvariationwereabove33.3%“-”or“.”meansthatthesurveyestimatesortheircoefficientofvariationcouldn’tbecalculated.

table 2.5

arsenic (creatinine adjusted) - arithmetic and geometric means of urine concentrations (µg/g) for on-reserve and crown land population aged 20 years old and older, Fnbi 2011


G.M.95%CI

10th95%CI

25th95%CI

50th95%CI

75th95%CI

90th95%CI

95th95%CI

ComparedtoCHMSG.M.

FNBITotal

Total 494 7.9010.25 5.02 1.85E 2.75 4.42 8.11 18.02 38.11E

↓8.81-11.70 3.94-6.40 1.13-2.58 2.10-3.40 3.63-5.21 7.01-9.21 15.07-20.98 24.26-51.96

F 302 8.9012.38 5.73 2.23 3.10 4.90 9.24 21.61E 51.07E

↓9.34-15.42 4.50-7.29 1.62-2.85 2.46-3.74 3.81-5.99 7.62-10.86 8.46-34.76 25.66-76.47

M 192 6.308.16 4.42 1.65E 2.44 3.77 7.11 17.52 20.24E

↓6.84-9.47 3.34-5.84 0.82-2.48 1.66-3.22 2.93-4.62 6.28-7.95 13.71-21.34 12.18-28.31

CHMS

Total 3465 0.1727.22 14.94 4.88 7.75 13.73 25.97 48.58 71.88

18.56-35.89 11.97-18.65 3.9-5.86 6.16-9.35 10.62-16.85 20.01-31.93 34.76-62.4 46.33-97.42

F 1839 0.1628.09 16.75 5.41 8.61 15.31 28.93 53.95 86.57

20.52-35.65 13.32-21.06 4.33-6.5 6.67-10.55 11.78-18.84 20.62-37.25 38.44-69.45 54.73-118.4E

M 1626 0.1826.34 13.30 4.5 7.04 11.97 22.83 41.69 63.56

15.53-37.16 10.67-16.57 3.54-5.46 5.6-8.47 9-14.93 17.98-27.68 27.89-55.48 44.56-82.57



table 2.6

arsenic - arithmetic and geometric means of urine concentrations (µg/l) for on-reserve and crown land population aged 20 years old and older, Fnbi 2011 – ecozones by age distributionFNBI

EcozoneAgegroup n

%<LOD

A.M.95%CI

G.M.95%CI

10th95%CI

25th95%CI

50th95%CI

75th95%CI

90th95%CI

95th95%CI

Total Total 495 8.111.63 4.47 F 2.21E 4.29 7.98 20.96 39.12

10.10-13.16 3.40-5.89 F 1.22-3.20 3.49-5.09 6.77-9.18 16.94-24.98 30.89-47.34

Total 20-39 203 10.810.61 4.40

38 national results

arsenic - arithmetic and geometric means of urine concentrations (µg/l) for on-reserve and crown land population aged 20 years old and older, Fnbi 2011 – ecozones by age distributionFNBI

EcozoneAgegroup n

%<LOD

A.M.95%CI

G.M.95%CI

10th95%CI

25th95%CI

50th95%CI

75th95%CI

90th95%CI

95th95%CI

Pacific 60-99 21 0.051.26E 14.53E 1.05E 2.29E F F 137.20 .29.38-73.14 9.40-22.47 0.43-1.68 1.10-3.49 F F 127.02-147.39 .

Prairies Total 82 36.6F F


arsenic (creatinine adjusted) - arithmetic and geometric means of urine concentrations (µg/g) for on-reserve and crown land population aged 20 years old and older, Fnbi 2011 – ecozones by age distributionFNBI

EcozoneAgegroup n

%<LOD

A.M.95%CI

G.M.95%CI

10th95%CI

25th95%CI

50th95%CI

75th95%CI

90th95%CI

95th95%CI

Boreal 40-59 62 1.64.85 4.19 2.15 3.02 3.90 4.97 8.55 11.99

4.22-5.48 3.77-4.65 1.61-2.69 2.25-3.80 3.45-4.35 3.83-6.11 5.85-11.24 8.78-15.20

Boreal 60-99 19 5.35.63 4.93 2.31E 3.22 5.36 6.01 8.45E 10.35

5.14-6.13 4.59-5.30 0.86-3.75 2.41-4.03 4.02-6.70 4.84-7.19 5.40-11.49 7.31-13.39

GreatLakes Total 71 1.4

7.22 4.97 2.16 2.78 3.61E 8.80 13.73 25.66E6.83-7.62 4.84-5.10 1.46-2.85 1.91-3.64 1.29-5.93 6.58-11.03 10.29-17.18 12.95-38.37

GreatLakes 20-39 25 0.0

8.53E 5.09 1.88 2.23 3.42 9.58E F .5.31-11.76 4.07-6.36 1.80-1.96 2.22-2.25 2.51-4.34 6.14-13.03 F .


7.29 5.40 2.33 2.89 4.58 8.07 11.43 18.966.20-8.37 5.23-5.58 2.10-2.56 1.95-3.82 3.18-5.98 6.67-9.47 10.54-12.32 .-.


4.51E 4.04E 2.49 3.35 3.37 4.50 8.05 9.711.90-7.11 2.69-6.07 2.45-2.52 3.35-3.36 2.38-4.35 3.14-5.86 6.36-9.75 .-.

Pacific Total 98 3.135.31 17.23 3.57E 7.52E 15.40 41.73E 103.07 123.45

27.99-42.63 12.52-23.71 2.25-4.89 4.68-10.37 10.55-20.26 15.77-67.69 99.93-106.21 106.40-140.50

Pacific 20-39 25 0.042.04 20.40 3.24 11.95E 15.24 F 117.62 130.76

33.16-50.92 18.40-22.61 2.25-4.22 4.43-19.47 13.53-16.96 F 104.90-130.34 123.51-138.00

Pacific 40-59 52 5.829.92E 14.92E F 7.15 14.65E F 81.83E 101.49E13.46-46.39 8.02-27.74 F 4.93-9.36 5.40-23.89 F 34.67-129.00 60.45-142.52

Pacific 60-99 21 0.028.71E 14.86E . 5.53 13.25E 45.02E 69.38E .17.07-40.35 8.96-24.62 . 4.17-6.90 8.17-18.33 19.35-70.70 42.89-95.87 .


40 national results

table 2.8

arsenic - arithmetic and geometric means of urine concentrations (µg/l) for on-reserve and crown land population aged 20 years old and older, Fnbi 2011 – ecozones by gender distributionFNBI

Ecozone Sex n%<LOD

A.M.95%CI

G.M.95%CI

10th95%CI

25th95%CI

50th95%CI

75th95%CI

90th95%CI

95th95%CI

Total Total 495 8.111.63 4.47 F 2.21E 4.29 7.98 20.96 39.12

10.10-13.16 3.40-5.89 F 1.22-3.20 3.49-5.09 6.77-9.18 16.94-24.98 30.89-47.34

Total F 302 8.910.90 4.22 F 1.93E 4.04 7.90 20.78 42.47E

8.43-13.37 3.28-5.44 F 1.10-2.77 3.25-4.83 5.40-10.40 16.02-25.54 28.01-56.93

Total M 193 6.712.35 4.73 F 2.66E 4.38 8.03 20.47 38.38E

10.15-14.54 3.42-6.54 F 1.65-3.68 2.99-5.78 6.96-9.09 14.59-26.36 22.98-53.78

Atlantic Total 88 0.0F F F F F F 39.05 FF F F F F F 37.41-40.69 F

Atlantic F 55 0.0F F F F F 23.24E 48.21 49.20EF F F F F 11.12-35.36 40.86-55.57 28.84-69.55

Atlantic M 33 0.0F 6.85E 2.77 F 7.39E 11.36E 25.12E FF 3.64-12.90 2.08-3.45 F 3.96-10.82 4.71-18.00 15.56-34.68 F

Boreal Total 156 3.84.69 3.34 0.83E 1.86E 3.50 5.65 8.80E 13.54E

3.69-5.69 2.59-4.31 0.47-1.19 0.88-2.84 2.44-4.56 5.05-6.26 5.31-12.30 8.31-18.78

Boreal F 92 4.34.14E 2.92E 0.79E 1.33E 2.86 4.93E 8.38E 11.27E2.47-5.82 2.09-4.09 0.50-1.07 0.54-2.11 1.96-3.75 2.93-6.93 3.73-13.04 4.39-18.14

Boreal M 64 3.15.22 3.80 0.91E 2.40E 4.30 5.86 9.24 14.42

4.82-5.61 3.17-4.55 0.38-1.43 1.24-3.56 4.06-4.54 5.32-6.40 7.88-10.61 12.77-16.06


8.16 5.30 2.07 2.95 4.21 7.57 15.41E F5.73-10.60 4.79-5.87 1.52-2.61 2.74-3.16 4.16-4.26 6.66-8.48 8.69-22.13 F

GreatLakes F 45 2.2

7.56 5.40 1.88E 3.48 6.03 8.69 14.36 18.897.48-7.65 5.15-5.67 0.92-2.85 2.80-4.16 4.29-7.77 8.08-9.31 14.15-14.56 18.56-19.23

GreatLakes M 26 0.0

8.78E 5.20 2.09 2.91 4.14 6.20 F F4.01-13.54 4.10-6.58 2.08-2.10 2.56-3.26 2.93-5.34 4.72-7.68 F F

Pacific Total 98 3.144.47 16.69 2.54 4.79 18.51E 40.18 119.99E 178.95

36.31-52.63 14.51-19.19 1.87-3.21 4.17-5.40 11.03-26.00 32.32-48.04 69.59-170.39 168.50-189.39

Pacific F 58 5.241.62E 18.56E 4.54 F 18.72E 50.70E 90.82 147.46E27.04-56.20 12.23-28.15 3.68-5.40 F 12.35-25.10 31.81-69.58 61.98-119.65 98.65-196.27

Pacific M 40 0.047.31 15.01 2.39 3.55E 12.70 32.51E F 177.85

34.67-59.95 11.68-19.30 2.24-2.55 1.60-5.49 9.37-16.03 20.25-44.77 F 157.64-198.05



table 2.9

arsenic (creatinine adjusted) - arithmetic and geometric means of urine concentrations (µg/g) for on-reserve and crown land population aged 20 years old and older, Fnbi 2011 – ecozones by gender distributionFNBI

Ecozone Sex n%<LOD

A.M.95%CI

G.M.95%CI

10th95%CI

25th95%CI

50th95%CI

75th95%CI

90th95%CI

95th95%CI

Total Total 494 7.910.25 5.02 1.85E 2.75 4.42 8.11 18.02 38.11E

8.81-11.70 3.94-6.40 1.13-2.58 2.10-3.40 3.63-5.21 7.01-9.21 15.07-20.98 24.26-51.96

Total F 302 8.912.38 5.73 2.23 3.10 4.90 9.24 21.61E 51.07E

9.34-15.42 4.50-7.29 1.62-2.85 2.46-3.74 3.81-5.99 7.62-10.86 8.46-34.76 25.66-76.47

Total M 192 6.38.16 4.42 1.65E 2.44 3.77 7.11 17.52 20.24E

6.84-9.47 3.34-5.84 0.82-2.48 1.66-3.22 2.93-4.62 6.28-7.95 13.71-21.34 12.18-28.31

Atlantic Total 88 0.0F 6.54E F F 6.93E F F FF 3.91-10.93 F F 4.02-9.84 F F F

Atlantic F 55 0.014.14E 9.50 2.72E 4.54E 9.90 17.74E 25.50 39.158.53-19.75 7.03-12.83 1.25-4.19 2.38-6.71 8.15-11.65 8.69-26.78 24.12-26.89 37.59-40.71

Atlantic M 33 0.0F F 1.58 F F 11.32 F FF F 1.52-1.65 F F 7.85-14.79 F F

Boreal Total 155 3.25.15 4.12 2.06 2.74 3.89 5.58 8.26 11.57E

3.77-6.53 3.50-4.85 1.58-2.54 2.27-3.21 3.25-4.53 4.57-6.59 6.21-10.31 4.67-18.47

Boreal F 92 4.36.04E 4.60 2.26 2.83 4.28 6.01 F F3.20-8.87 3.46-6.13 1.76-2.76 2.22-3.45 3.15-5.40 4.09-7.94 F F

Boreal M 63 1.64.29 3.70 1.87 2.67 3.57 4.70 7.39 8.80E

4.19-4.39 3.47-3.95 1.38-2.37 2.20-3.14 3.14-4.01 4.25-5.15 6.25-8.53 5.29-12.31


7.22 4.97 2.16 2.78 3.61E 8.80 13.73 25.66E6.83-7.62 4.84-5.10 1.46-2.85 1.91-3.64 1.29-5.93 6.58-11.03 10.29-17.18 12.95-38.37

GreatLakes F 45 2.2

6.86E 5.62 2.32 F 4.73E 9.58 11.69 14.953.82-9.90 4.21-7.49 2.22-2.41 F 2.81-6.65 8.49-10.66 9.74-13.63 12.59-17.31

GreatLakes M 26 0.0

7.59E 4.38 1.91 2.49E 3.33 F F .4.03-11.16 3.22-5.96 1.82-2.01 1.43-3.55 2.70-3.96 F F .

Pacific Total 98 3.135.31 17.23 3.57E 7.52E 15.40 41.73E 103.07 123.45

27.99-42.63 12.52-23.71 2.25-4.89 4.68-10.37 10.55-20.26 15.77-67.69 99.93-106.21 106.40-140.50

Pacific F 58 5.246.13E 21.10E 3.82 7.41E F 68.40E 123.04 140.2329.43-62.83 13.15-33.85 3.28-4.35 4.43-10.39 F 29.35-107.46 105.20-140.88 110.05-170.40

Pacific M 40 0.024.52 14.07 F F 13.99 19.47 F .

19.05-29.99 11.73-16.89 F F 11.79-16.19 18.19-20.74 F .


42 national results

8.2.2 referencesATSDR(AgencyforToxicSubstancesandDiseaseRegistry).(2007).ToxicologicalProfileforArsenic.Retrievedfromwww.atsdr.cdc.gov/toxprofiles/tp2.html

CentersforDiseaseControlandPrevention(CDC).NationalBiomonitoringProgram.BiomonitoringsummaryforArsenic(2012).[online]AvailableatURL:http://www.cdc.gov/biomoni-toring/biomonitoring_summaries.html

EnvironmentCanada&HealthCanada.(1993).PrioritySubstancesListAssessmentReport:Arsenic.Ottawa:SupplyandServicesCanada.

HealthCanada.(2006).GuidelinesforCanadianDrinkingWaterQuality:GuidelineTechnicalDocument–Arsenic.Ottawa:WaterQualityandHealthBureau,HealthyEnvironmentsandConsumerSafetyBranch,HealthCanada.Retrievedfromwww.hc-sc.gc.ca/ewh-semt/pubs/water-eau/arsenic/index-eng.php

HealthCanada(2010).ReportonHumanBiomonitoringofEnvironmentalChemicalsinCanada.ResultsoftheCanadianHealthMeasuresSurveyCycle1(2007-2009).Retrievedfromwww.healthcanada.gc.ca

PMRA(PestManagementRegulatoryAgency).(2005).FactSheetonChromatedCopperArsenate(CCA)TreatedWood.HealthCanada.Retrievedfromwww.hc-sc.gc.ca/cps-spc/pubs/pest/_fact-fiche/cca-acc/index-eng.php

Schneider,G.,&Krivan,V.(1993).Multi-elementanalysisofto-baccoandsmokecondensatebyinstrumentalneutronactiva-tionanalysisandatomicabsorptionspectrometry.InternationalJournalofEnvironmentalAnalyticalChemistry,53,87–100.


8.3 cadmium

Cadmium(Cd)isanaturallyoccurringsoft,silverywhite,bluetingedmetalmainlyreleasedintotheenvironmentasaresultofhumanactivities.Itcanalsoentertheenvironmentasaresultofnaturalprocesses,includingforestfires,volcanicemissions,andweatheringofsoilandbedrock.Industrialbasemetalsmeltingandrefiningprocesses,andcombustionprocesses,suchascoal-firedelectricalplantsandwasteincinerationreleasescadmiumintotheatmosphereasaby-product(CCME,1996).

Cadmiumisprimarilyusedinthemanufactureofnickel-cadmiumbatteries,inindustrialcoatingsandelectroplating,inpigments,andasaplasticstabilizerinPVCplasticsandispresentinmetalalloysheets,wires,rods,solders,andshieldsforvariousindustrialapplications(EnvironmentCanada&HealthCanada,1994).Itcanbefrequentlyfoundasanimpurityingalvanizedpipesandcanleachintodrinkingwater(HealthCanada,1986).SmokersareexposedtocadmiumviainhalationofcigarettesmokesincethetobaccoofonetypicalCanadiancigarettecontainsapproximately1μgofcadmium,ofwhich6–20%maybetransferredinmainstreamsmoke,basedonma-chinesmokedyields(Hammond&O’Connor,2008).Smoking20cigarettesperdaycanthereforeresultinanadditionaldailyexposureofapproximately1.2–4μgofcadmium.Themainex-posureofcadmiumfornon-smokersisthroughfood,althoughoccupationalexposurecanalsobeasignificantsource.

QuebechasestablishedanOccupationalExposureGuidancevalueforCadmiuminBloodas5μg/L(44.49nmol/L)(INSPQ,2008).

HealthCanadahasestablishedamaximumacceptableconcen-tration(MAC)of0.005mg/L(5μg/L)indrinkingwater(HealthCanada,1986).

8.3.1 FindingsCadmiumwasmeasuredinbloodandurineoftheFNBIsam-pleandispresentedasμg/Lblood,μg/Lurineandμg/gcreati-nine(Tables3.1–3.9).Cadmiumlevelscanprovidephysiciansandhealthofficialswithreferencerangesthatcanbeusedtodeterminewhetherpeoplehavebeenexposedtohigherlevelsofcadmiumthanarefoundinotherpopulations.

Levelsofbloodandurinarycadmiumreflectbothrecentandcumulativeexposure.Findingameasurableamountofcadmiumdoesnotnecessarilymeanthatanadversehealtheffectwilloccur.

Bloodcadmiumlevelsobservedin(total,femaleandmale)theFNBIsampleweresignificantlyhigher(about2timeshigher)thanlevelsobservedintheCHMSsample.UrinarycadmiumlevelsseenintheFNBIsample(totalandfemale)weresignifi-cantlyhigher(about1.5-timeshigher)thanlevelsseenintheCHMSsample.

44 national results

table 3.1

cadmium - arithmetic and geometric means of blood concentrations (µg/l) for on-reserve and crown land population aged 20 years old and older, Fnbi 2011


G.M.95%CI

10th95%CI

25th95%CI

50th95%CI

75th95%CI

90th95%CI

95th95%CI

ComparedtoCHMSG.M.

FNBITotal

Total 473 0.001.71 0.96 0.11E 0.35 1.40 2.53 3.85 4.65

↑1.49-1.92 0.84-1.10 0.06-0.16 0.28-0.42 1.02-1.78 2.22-2.83 3.43-4.26 4.02-5.28

F 285 0.001.67 1.00 0.19E 0.41E 1.15E 2.48 3.83 4.65

↑1.33-2.02 0.80-1.25 0.12-0.26 0.26-0.57 0.58-1.73 2.05-2.91 3.16-4.51 4.08-5.21

M 188 0.001.74 0.93 0.11 0.32E 1.49E 2.66 3.85 4.62

↑1.50-1.98 0.74-1.16 0.08-0.13 0.19-0.44 0.98-2.00 2.22-3.10 3.30-4.40 3.71-5.53

CHMS

Total 3463 1.010.87 0.42 0.12 0.19 0.34 0.78 2.77 3.8

0.80-0.95 0.39-0.45 0.11-0.14 0.18-0.21 0.31-0.36 0.66-0.91 2.37-3.16 3.41-4.2

F 1836 0.540.92 0.47 0.15 0.23 0.37 0.79 2.81 4.03

0.83-1.00 0.44-0.51 0.13-0.16 0.21-0.25 0.33-0.41 0.66-0.92 2.4-3.22 3.47-4.59

M 1627 1.540.82 0.38 0.11 0.16 0.28 0.76 2.61 3.73

0.71-0.94 0.33-0.43 0.1-0.12 0.14-0.18 0.24-0.31 0.53-1 2.1-3.12 3.23-4.22


tables 3.2

cadmium - arithmetic and geometric means of blood concentrations (µg/l) for on-reserve and crown land population aged 20 years old and older, Fnbi 2011 – ecozones by age distributionFNBI

EcozoneAgegroup n

%<LOD

A.M.95%CI

G.M.95%CI

10th95%CI

25th95%CI

50th95%CI

75th95%CI

90th95%CI

95th95%CI

Total Total 473 0.01.71 0.96 0.11E 0.35 1.40 2.53 3.85 4.65

1.49-1.92 0.84-1.10 0.06-0.16 0.28-0.42 1.02-1.78 2.22-2.83 3.43-4.26 4.02-5.28

Total 20-39 187 0.01.96 1.24 F 0.60E 1.69 2.68 3.95 5.08

1.69-2.24 0.99-1.56 F 0.40-0.81 1.42-1.96 2.41-2.96 3.17-4.73 4.03-6.14

Total 40-59 206 0.01.70 0.95 F 0.32 1.38E 2.68 3.86 4.28

1.26-2.14 0.78-1.17 F 0.28-0.36 0.62-2.13 1.82-3.53 3.22-4.51 3.45-5.11

Total 60-99 80 0.00.85E 0.41E F F F F F 3.470.37-1.34 0.24-0.73 F F F F F 2.71-4.23

Atlantic Total 78 0.01.88 1.27 0.27 0.50 1.76 2.40 3.74 4.52

1.65-2.11 1.08-1.50 0.24-0.29 0.34-0.67 1.60-1.92 2.29-2.50 3.14-4.35 3.15-5.88

Atlantic 20-39 24 0.02.18 1.68E 0.40E F 1.83 2.34 . .

1.73-2.62 1.14-2.49 0.14-0.67 F 1.59-2.07 1.89-2.79 . .

Atlantic 40-59 39 0.01.86 1.13 0.13E 0.36E 1.60 2.68 3.71 4.00

1.52-2.20 1.05-1.23 0.06-0.19 0.20-0.53 1.17-2.04 2.07-3.28 2.80-4.62 3.83-4.17

Atlantic 60-99 15 0.01.02E 0.75 0.29 0.32 0.68E F 1.84 2.960.44-1.60 0.61-0.92 .-. 0.29-0.36 0.35-1.00 F .-. .-.


cadmium - arithmetic and geometric means of blood concentrations (µg/l) for on-reserve and crown land population aged 20 years old and older, Fnbi 2011 – ecozones by age distributionFNBI

EcozoneAgegroup n

%<LOD

A.M.95%CI

G.M.95%CI

10th95%CI

25th95%CI

50th95%CI

75th95%CI

90th95%CI

95th95%CI

Boreal Total 152 0.01.70 0.95 F 0.33E 1.36E 2.45 3.90 4.70

1.32-2.08 0.76-1.18 F 0.12-0.55 0.88-1.84 2.09-2.81 2.88-4.92 3.71-5.69

Boreal 20-39 73 0.02.05 1.47 0.41E F 1.81 2.53 4.01 5.13E

1.71-2.39 1.21-1.80 0.17-0.65 F 1.53-2.08 2.18-2.88 2.78-5.24 3.37-6.89

Boreal 40-59 60 0.01.50E 0.68E 0.08 0.19 F F 3.91 4.580.75-2.24 0.45-1.01 0.06-0.10 0.16-0.23 F F 3.32-4.50 3.59-5.57

Boreal 60-99 19 0.00.67E 0.32E F F 0.21E 1.01E 2.02E 2.15E0.44-0.91 0.20-0.51 F F 0.10-0.33 0.37-1.64 1.28-2.76 1.41-2.89


1.95 0.99 0.10 0.30 1.25E 3.43 4.66 5.371.62-2.28 0.95-1.03 0.10-0.11 0.23-0.37 0.76-1.73 3.15-3.71 3.77-5.55 5.25-5.49


2.68E F 0.27 0.76E F 3.93E 5.37 5.641.50-3.86 F 0.26-0.28 0.37-1.15 F 2.15-5.70 .-. .-.


2.02E 1.23 0.22 0.36E F F 3.75 4.030.78-3.26 1.18-1.29 0.20-0.24 0.23-0.50 F F 3.62-3.88 .-.


F F . . F F 0.97E 1.09F F . . F F 0.35-1.59 .-.

Pacific Total 96 0.01.28 0.69E 0.09E F F 2.12E 2.91 3.21

0.87-1.68 0.40-1.17 0.06-0.11 F F 1.25-2.99 2.88-2.94 3.09-3.34

Pacific 20-39 22 0.0F F . F F F 2.66E .F F . F F F 1.02-4.31 .

Pacific 40-59 51 0.01.63 1.15 F 0.62E 1.34 2.53 3.09 3.25

1.32-1.94 0.83-1.58 F 0.23-1.00 0.93-1.75 2.45-2.61 2.92-3.26 2.87-3.64

Pacific 60-99 23 0.01.36 0.89 0.37E 0.41 0.63 2.04 3.49 .

1.19-1.53 0.75-1.06 0.20-0.54 0.30-0.52 0.60-0.66 1.63-2.46 2.64-4.34 .

Prairies Total 77 0.01.83 1.26 0.29E F 1.86 2.66 3.37 3.73

1.38-2.29 0.94-1.71 0.18-0.39 F 1.46-2.25 1.87-3.45 2.93-3.80 3.25-4.21

Prairies 20-39 44 0.01.80 1.26E F F F 2.65 3.31 3.42

1.25-2.35 0.71-2.24 F F F 2.07-3.23 3.16-3.47 2.69-4.14

Prairies 40-59 24 0.01.97E 1.56E 0.35 F F 2.60E 3.32E 3.770.94-3.01 0.94-2.60 .-. F F 1.58-3.61 1.88-4.77 .-.

Prairies 60-99 9 0.0F F . 0.18E F F . .F F . 0.07-0.28 F F . .


46 national results

table 3.3

cadmium - arithmetic and geometric means of blood concentrations (µg/l) for on-reserve and crown land population aged 20 years old and older, Fnbi 2011 – ecozones by gender distributionFNBI

Ecozone Sex n%<LOD

A.M.95%CI

G.M.95%CI

10th95%CI

25th95%CI

50th95%CI

75th95%CI

90th95%CI

95th95%CI

Total Total 473 0.01.71 0.96 0.11E 0.35 1.40 2.53 3.85 4.65

1.49-1.92 0.84-1.10 0.06-0.16 0.28-0.42 1.02-1.78 2.22-2.83 3.43-4.26 4.02-5.28

Total F 285 0.01.67 1.00 0.19E 0.41E 1.15E 2.48 3.83 4.65

1.33-2.02 0.80-1.25 0.12-0.26 0.26-0.57 0.58-1.73 2.05-2.91 3.16-4.51 4.08-5.21

Total M 188 0.01.74 0.93 0.11 0.32E 1.49E 2.66 3.85 4.62

1.50-1.98 0.74-1.16 0.08-0.13 0.19-0.44 0.98-2.00 2.22-3.10 3.30-4.40 3.71-5.53

Atlantic Total 78 0.01.88 1.27 0.27 0.50 1.76 2.40 3.74 4.52

1.65-2.11 1.08-1.50 0.24-0.29 0.34-0.67 1.60-1.92 2.29-2.50 3.14-4.35 3.15-5.88

Atlantic F 47 0.02.03 1.31 F 0.50E 1.64 2.92 4.52E 4.65E

1.84-2.22 1.12-1.53 F 0.29-0.72 1.16-2.13 2.03-3.81 2.81-6.22 3.04-6.27

Atlantic M 31 0.01.73 1.24E F 0.39E 1.78E 2.19 3.30 3.40

1.45-2.02 0.78-1.98 F 0.16-0.61 0.82-2.74 1.85-2.53 2.63-3.96 3.04-3.75

Boreal Total 152 0.01.70 0.95 F 0.33E 1.36E 2.45 3.90 4.70

1.32-2.08 0.76-1.18 F 0.12-0.55 0.88-1.84 2.09-2.81 2.88-4.92 3.71-5.69

Boreal F 88 0.01.68 0.98 F 0.41E F 2.49 3.79 4.68

1.21-2.15 0.74-1.30 F 0.20-0.63 F 1.97-3.00 2.62-4.96 3.71-5.65

Boreal M 64 0.01.72 0.92 F 0.26E 1.42E 2.39E 3.89 4.56

1.36-2.08 0.76-1.13 F 0.14-0.37 0.94-1.91 1.61-3.18 2.96-4.83 3.56-5.56


1.95 0.99 0.10 0.30 1.25E 3.43 4.66 5.371.62-2.28 0.95-1.03 0.10-0.11 0.23-0.37 0.76-1.73 3.15-3.71 3.77-5.55 5.25-5.49

GreatLakes F 4 0.0

F F F F F 3.37E 3.99E 5.20EF F F F F 1.77-4.98 2.43-5.56 2.91-7.49

GreatLakes M

260.0

2.15 F . F F F 4.67 5.31

1.55-2.74 F . F F F 4.47-4.88 .-.

Pacific Total 960.0

0.0

1.28 0.69E 0.09E F F 2.12E 2.91 3.21

0.87-1.68 0.40-1.17 0.06-0.11 F F 1.25-2.99 2.88-2.94 3.09-3.34

Pacific F 57 .01.13 0.67 . 0.23E 0.69 1.53 2.46 3.45

0.92-1.35 0.55-0.82 . 0.11-0.35 0.57-0.80 1.33-1.73 1.85-3.08 2.75-4.16

Pacific M 39 0.01.42E F . F F 2.65E 2.92 3.160.68-2.17 F . F F 1.31-3.99 2.88-2.96 3.06-3.26

Prairies Total 77 0.01.83 1.26 0.29E F 1.86 2.66 3.37 3.73

1.38-2.29 0.94-1.71 0.18-0.39 F 1.46-2.25 1.87-3.45 2.93-3.80 3.25-4.21

Prairies F 9 0.02.03 1.54 0.35 F 2.06E 2.86 3.40 3.70

1.45-2.61 1.11-2.14 0.31-0.40 F 1.32-2.79 2.10-3.62 3.09-3.72 3.34-4.05

Prairies M28

0.01.64E 1.03E F F 1.62E 2.30E 3.34 3.55

0.99-2.29 0.57-1.89 F F 0.81-2.43 1.32-3.27 2.41-4.28 3.00-4.11



table 3.4

cadmium - arithmetic and geometric means of urine concentrations (µg/l) for on-reserve and crown land population aged 20 years old and older, Fnbi 2011


G.M.95%CI

10th95%CI

25th95%CI

50th95%CI

75th95%CI

90th95%CI

95th95%CI

ComparedtoCHMSG.M.

FNBITotal

Total 495 2.000.79 0.54 0.11E 0.33 0.61 1.02 1.61 2.07

↑0.72-0.86 0.47-0.63 0.05-0.17 0.27-0.39 0.54-0.67 0.94-1.11 1.44-1.78 1.81-2.33

F 302 1.300.83 0.56 0.11E 0.31 0.60 1.08 1.74 2.23

↑0.76-0.90 0.49-0.64 0.05-0.17 0.26-0.37 0.53-0.67 0.96-1.20 1.64-1.83 1.99-2.47

M 193 3.100.75 0.53 F 0.34 0.61 1.00 1.47 1.76

-0.64-0.86 0.42-0.66 F 0.25-0.42 0.51-0.72 0.83-1.17 1.09-1.86 1.42-2.10

CHMS

Total 3474 8.000.60 0.37 0.1 0.21 0.41 0.74 1.31 1.76

0.57-0.63 0.34-0.41 40%ofsampleswerebelowLOD,thepercentiledistributionisreportedbutmeanswerenotcalculatedEmeansthatthesurveyestimatesshouldbeusedwithcaution.Theirassociatedcoefficientofvariationarebetween16.6%and33.3%Fmeansthatthesurveyestimatesweretoounreliabletobepublished.Theirassociatedcoefficientofvariationwereabove33.3%“-”or“.”meansthatthesurveyestimatesortheircoefficientofvariationcouldn’tbecalculated.

48 national results

table 3.6

cadmium - arithmetic and geometric means of urine concentrations (µg/l) for on-reserve and crown land population aged 20 years old and older, Fnbi 2011 – ecozones by age distributionFNBI

EcozoneAgegroup n

%<LOD

A.M.95%CI

G.M.95%CI

10th95%CI

25th95%CI

50th95%CI

75th95%CI

90th95%CI

95th95%CI

Total Total 495 2.00.79 0.54 0.11E 0.33 0.61 1.02 1.61 2.07

0.72-0.86 0.47-0.63 0.05-0.17 0.27-0.39 0.54-0.67 0.94-1.11 1.44-1.78 1.81-2.33

Total 20-39 203 3.90.73 0.50 F 0.33 0.55 1.01 1.44 1.73

0.61-0.84 0.40-0.62 F 0.27-0.38 0.50-0.61 0.80-1.21 1.11-1.76 1.45-2.01

Total 40-59 213 0.90.86 0.59 F 0.36 0.67 1.07 1.79 2.57

0.75-0.96 0.51-0.68 F 0.24-0.47 0.58-0.75 0.86-1.27 1.49-2.10 1.99-3.15

Total 60-99 79 0.00.86 0.63 F 0.43 0.72 1.03 1.69 2.26

0.79-0.94 0.52-0.76 F 0.30-0.56 0.60-0.85 0.94-1.13 1.51-1.88 1.83-2.68

At

Documents

First Nations Biomonitoring Initiative: National Results 2011 by … · 2017. 7. 20. · National Results (2011). Assembly of First Nations, 2013. Print. About the Assembly of First