Abstract
Mercury, a potent toxin that poses serious risks to human health, particularly for pregnant women and young children, is widely present due to artisanal and small-scale gold mining (ASGM), which impacts water quality. The objective of this study was to evaluate methylmercury exposure among pregnant women in communities downstream from ASGM sites. We characterized hair total mercury (THg) concentrations among 148 pregnant women across 24 communities in the Tumbes region of Peru, downstream from ASGM sites in Ecuador. Using purposeful sampling, we classified communities into three exposure risk zones: Puyango-Tumbes River watershed, Coast, and Zarumilla. The mean THg concentration was 2.08 µg/g ± 1.36, with 45% of participants (67/148) exceeding UNEP/WHO exposure limits (>2.0 µg/g). The median was 1.84 with an interquartile range (IQR) from 1.01 to 2.83. Median THg levels were significantly higher in the Puyango-Tumbes River region (2.72 µg/g; IQR: 1.66-3.55) compared with Zarumilla (1.61 µg/g; IQR: 0.67-2.63; P = 0.001) and to the Coast (1.71 µg/g; IQR: 1.13-2.50; P = 0.01), suggesting that living close to the Puyango-Tumbes River may be associated with a higher mercury exposure risk. After controlling for potential confounders, individuals in the Puyango-Tumbes watershed exhibited a significant 57% higher expected geometric mean of hair THg compared with Zarumilla (95% CI: 0.1-146.2%). These findings underscore the importance of identifying high-risk regional populations and ongoing biomonitoring of the Puyango-Tumbes River watershed.