Chemosphere 164 (2016) 462e468

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Chemosphere
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Assessment of sh consumption and mercury exposure among

pregnant women in Jamaica and Trinidad & Tobago
Phylicia Ricketts a, *, Niladri Basu b, Horace Fletcher c, Mitko Voutchkov a, Bharat Bassaw d
a
Faculty of Science & Technology, The University of the West Indies, Mona, Kingston 7, Jamaica
b
Faculty of Agricultural and Environmental Sciences, McGill University, Montreal, Quebec, Canada
c
Faculty of Medical Sciences, The University of the West Indies, Mona, Kingston 7, Jamaica
d
Faculty of Medical Sciences, The University of the West Indies, St. Augustine, Trinidad and Tobago

h i g h l i g h t s

The preference of maternal sh intake is dependent on the country's captured sh production.

Pregnant women in the Caribbean are susceptible to mercury exposure from sh intake.

Consumers of large ocean pelagic sh have higher placental mercury concentrations.

Consumers of small pelagic and reef nsh have lower placental mercury concentrations.

a r t i c l e i n f o a b s t r a c t

Article history: Background: Fish is an essential and traditional element in the diet of most Caribbean people. However it
Received 10 May 2016 also contains methylmercury which can have severe effects on fetal neurodevelopment. The objective of
Received in revised form this study was to assess the sh intake of a selected group of pregnant women from Jamaica and Trinidad
8 August 2016
& Tobago and evaluate prenatal mercury exposure, using the placenta as a biomarker.
Accepted 10 August 2016
Available online 7 September 2016
Method: Food frequency questionnaires and placental samples were obtained from participating par-
turients at the time of delivery at the University Hospital of the West Indies in Kingston, Jamaica
Handling Editor: Keith Maruya (N 100, from November 2012 to March 2013) and the Mt Hope Women's hospital in St Joseph, Trinidad
& Tobago (N 30, in June 2015). The participants were asked to identify the species of sh and the
Keywords: frequency of consumption. Placental samples were analysed for mercury using cold vapour atomic
Mercury absorption.
Exposure assessment Results: The sh consumption preferences for pregnant women, varies based on the marine sh catch
Biomarkers production of each country. The main sh species that contributed to the highest estimated methyl-
Placenta
mercury exposure in Jamaica and Trinidad & Tobago were cod and shark, respectively. There was a weak
Fish consumption
association between maternal sh intake and placental mercury concentrations. The mean placental
Caribbean
mercury concentrations in Jamaica and Trinidad & Tobago were 0.74 0.5 mg/kg and 1.46 0.6 mg/kg,
wet weight respectively.
Conclusion: The results from this study showed an inuence of Caribbean sh intake preferences on
mercury exposure and thus a recommendation for continuous bio-monitoring for public health purposes.
2016 Elsevier Ltd. All rights reserved.

1. Introduction of livelihood in the Caribbean community (CARICOM). The overall

Fish is a traditional and essential element in the diet of most
Caribbean people. The shing industry is also an important source
* Corresponding author. Present address: Department of Physics, The University
of the West Indies, Mona, Kingston 7, Jamaica.
E-mail address: phylicia.ricketts@mymona.uwi.edu (P. Ricketts).
consumption of sh per person in Caribbean countries is about
31 kg/yr (Masters, 2012). This is well above the global average per
person of 16.4 kg/yr in 2006 (Secretariat, 2016). The sh con-
sumption per person in some Caribbean countries, could be as high
as 69 kg/yr and 66 kg/yr in Antigua & Barbuda and Anguilla,
respectively (Masters, 2012). Fish is critical for a healthy diet. It
contains omega 3 fatty acids and vitamins D and B12, which are
important for brain development and reducing the risk of heart

http://dx.doi.org/10.1016/j.chemosphere.2016.08.054
0045-6535/ 2016 Elsevier Ltd. All rights reserved.
 P. Ricketts et al. / Chemosphere 164 (2016) 462e468
attacks (Washington State Department of Health, 2016). However,
there has been heightened concern about the presence of toxic
methylmercury in sh (American Heart Association, 2015). Fish
consumption was shown to be a major contributor to daily meth-
ylmercury intake for coastal populations (Cheng et al., 2013).
Mercury exposure is of global concern in pregnant women
because of placental transfer to the fetus (Karagas et al., 2012). The
usual biomarkers for determining prenatal exposure to mercury are
maternal hair, maternal blood and cord blood (Sakamoto et al.,
2007). While these have some value, there are noteworthy limita-
tions. For example, mercury concentrations in maternal blood and
hair may vary over different periods of pregnancy, and the rela-
tionship between mercury in cord blood and maternal blood can
uctuate (Basu et al., 2014). Some of these limitations may be
overcome by studying the placenta, which integrates fetal exposure
for almost 36 weeks. In addition, the placenta is considered a non-
invasive, real time monitoring specimen that can reveal both
maternal and fetal exposure to elements (Iyengar and Rapp, 2001).
Therefore the mercury concentrations in placenta could be a suit-
able biomarker, though few studies have examined maternal sh
consumption and placental mercury concentrations (Ask et al.,
2002; Bjornberg et al., 2005; Hsu et al., 2007).
Research on mercury exposure in the Caribbean is increasing. In
a previous Caribbean study, the most common sh species
consumed in Barbados was ying sh, marlin and tuna. It was
found that hair mercury concentrations for Barbadians signicantly
increased when participants consumed high risk sh (such as tuna
and marlin) (Drescher et al., 2014). Another study found that
mercury concentrations in the blood of pregnant women in the
Caribbean were two times higher when compared to Canada and
the US. This was primarily due to the frequency and sh species
preference of Caribbean people. The study also showed that blood
mercury concentrations vary across each island (Forde et al., 2014).
The purpose of the study was twofold: A) to characterize the sh
consumption patterns of a selected group of pregnant women from
Kingston in Jamaica and St. Joseph in Trinidad & Tobago, and B) to
increase understanding of prenatal mercury exposure by charac-
terizing mercury levels in the placenta. The outcomes of this study
are expected to increase understanding of sh consumption in the
Caribbean region along with associated concerns of mercury
exposure, and together such research is needed for the purposes of
public health but also to help countries meet obligations associated
with the UN Minamata Convention on Mercury Pollution (Gustin
 
g mg
Amount of fish ingested d
* Hg concentration in the ingested fish
Body weight kg
et al., 2016).
2. Materials and methods
2.1. Participants
Ethical approval was granted from the ethics committee of the
Faculty of Medical Sciences at The University of the West Indies
Mona and St. Augustine campuses. Placental samples were
collected and dietary surveys administered to participants at the
University Hospital of the West Indies in Kingston, Jamaica
(N 100) and the Mt. Hope Women's hospital in St. Joseph,
463
Trinidad & Tobago (N 30). In both sites participants were
recruited via convenience sampling. The sample collection was
carried out during November 2012eApril 2013 and June 2015,
respectively. Informed consent was obtained from each participant.
The female population of child bearing age (18e44 years) for Ja-
maica and Trinidad & Tobago were approximately 591,567 and
264,424 respectively (Statistical Institute of Jamaica, 2014; Central
Statistical Ofce, 2015). Each tertiary teaching hospital institution
is situated in the capital cities for both countries. There was no
known occupational exposure to mercury among the participants.
Both countries have different sh consumption preferences due to
their sheries sector mechanism.
2.2. Fish intake
Food frequency questionnaires were administered to partici-
pating parturients at the time of delivery. The frequency of sh
consumption and the approximate amount of sh intake, using a
Food Frequency Questionnaires (FFQ) similar to ones used previ-
ously (Bjornberg et al., 2005; Goodrich et al., 2016). In the current
study, the participants were asked questions on 12 sh and 4
canned sh known to be commonly consumed in both countries.
They were also given an option to suggest other types of sh not
included in the list. Participants completed surveys detailing their
sh consumption patterns within the last 3 months. The intake
options included never, once/month, 2e3 times per month, once/
week, 2e3 times per week, 4 or more times per week. Participants
also reported consumption frequency, portion size and species.
2.3. Methylmercury intake
The mean mercury concentrations in sh were obtained from a
compilation of the literature in Table 1. The mercury concentration
in some Jamaican sh was obtained from a preliminary seafood
assessment (Fletcher et al., 2005). The mercury concentration of the
remaining varieties of sh was obtained from a large database
maintained by the U.S. Food and Drug Administration (Karimi et al.,
2012). The estimated methylmercury ingested dose was calculated
based on daily sh intake, the mercury concentration in each
species and body weight. The mean body weight for participants
was 77 kg.
The basic equation to estimate methylmercury intake per body
weight (mg/kg/d) is (World Health Organization, 2008):
 
g
2.4. Mercury analysis
Approximately a quarter of the at part of the placenta from the
region of the umbilical cord was severed with a surgical blade. It
was then placed in a sealed plastic bag and stored in a freezer
at 18  C. The samples were dried in the drying oven (Memmert,
Schwabach, Germany) at 60  C. The oven was set to maintain a
constant temperature for approximately 96 h. The sample was
removed from the oven and weighed intermittently every 30 min
until a constant dry weigh was obtained. Mercury levels were
measured following United States Environmental Protection
Agency (US EPA) method 245.6 using the 400 A mercury analyzer.
464 P. Ricketts et al. / Chemosphere 164 (2016) 462e468

Table 1
Mercury concentrations (mg/g) in selected sh species and reported maternal sh consumption patterns by study participants from Kingston, Jamaica and St. Joseph in Trinidad,
as determined through self-reported surveys at the time of pregnancy.

Common name Scientic name Hg concentration/mg/g Fish consumption pattern (median)

Kingston St. Joseph

Shark Carcharhinus 1.77 none 1/mth

Kingsh Scomberomorus cavalla 0.64b none 2e3/mth
Carite Scomberomorus 0.39 none 1/mth
White grunt Haemulon plumieri 0.38 1/mth none
Tuna-Bluen (canned) Thunnus thynnus 0.29 2e3/mth 1/week
Yellowtail snapper e 0.19 2e3/mth none
Sea Trout Cynoscion regalis 0.17b 2e3/mth 2e3/mth
Tuna-Albacore (fresh) T Alalunga 0.17 none 1/mth
Cod Gadus morhua 0.10 2e3/mth 2e3/mth
Other 0.10 1/mth 1/mth
Shad Alosa aestivalis 0.09 1/mth none
Croaker Micropogonias furnieri 0.07 none 1/week
Redtail snapper Lutjanus campechanus 0.05b 2e3/mth 1/week
Tilapia Oreochromis niloticus 0.05 2e3/mth none
Mackerel-jack (canned) Trachurus murphyi 0.05 2e3/mth 2e3/mth
Salmon-Pink (canned) Oncorhynchus gorbuscha 0.04 2e3/mth 1/mth
Herring-Atlantic Clupea harengus 0.03 1/mth none
Sardines (canned) Sardina pilchardus 0.02 1/week 2e3/week

Source: (Karimi et al., 2012), b(Fletcher et al., 2005).

About 0.3 g of dried placental tissue sample was placed in a
biochemical oxygen demand (BOD) bottle with 8 ml of concen-
trated sulfuric acid and 2 ml of concentrated nitric acid. The BOD
bottle was placed in a water bath maintained at 80  C until the
tissue completely dissolved (approximately 30 min). The sample
was cooled and 15 ml of potassium permanganate and 8 ml of
potassium persulfate solutions were added and returned to the
water bath and digested for an additional 90 min at 30  C. The
digested sample was diluted with 55 ml of reagent water and 6 ml
of sodium chloride-hydroxylamine sulfate solution was added to
reduce the excess permanganate. Then 5 ml of stannous chloride
solution was added. A batch of 12 samples was measured daily over
a 6 weeks period. Each sample was measured once, with blanks
repeated twice and certied reference material measured after
every batch. The certied reference material used was IAEA 407
(Fish homogenate). An instrument calibration curve was estab-
lished by plotting standard concentrations against instrument
reading absorbance. A regression statistics, R2 0.998 was calcu-
lated. The level of detection (LOD) for mercury in placenta was
0.5 mg/kg. The average recovery of the reference material was found
to be 77e80%.
three months of pregnancy. Cod was the most popular sh species
consumed among participants from Kingston (n 57%), while
shark was the most popular consumed sh species among par-
ticipants from St. Joseph (n 37%) (Fig. 1). The most common sh
consumed by participants sampled from each site were cod, red-
tail snapper, sardines (canned), mackerel (canned) and tuna
(canned). The least consumed sh consumed by participants
sampled from each site was salmon (canned). The following sh
species were classied as other by a few participants: sea bass
(Atractoscion nobilis), doctor sh (Acanthurus chirurgus), mullet
(Mugil cephalus), Croaker- Atlantic (Micropogonias undulates) and
grouper (Myctoperca tigris). The frequency of consumption also
differed. In participants from Kingston, the most popular sh was
consumed 2e3 times per month (Table 1), while in St. Joseph the
most popular sh was consumed once per month (Table 1). The
total daily sh intake per person (g/day) was higher in participants
from Kingston (38.5 g/day) than in St. Joseph (20.9 g/day)
(Table 2).
3.2. Methylmercury ingested dose

2.5. Statistical analysis
All data analysis was performed using Windows SPSS version 19.
The data was not normally distributed. Descriptive statistics were
examined for each variable. Estimated sh consumption was
normalized to daily intake. Initial assessment of residual and
normal probability plots were used to identify outliers. The outliers
were removed from the subsequent analyses. Linear regression
analysis (multiple R) was used to determine the relationship be-
tween maternal daily sh intakes and placental mercury concen-
trations. There were about 48% of sample concentrations that were
found to be below the method detection limit (MDL), these were
classied as non-detects. The Kaplan-Meier approach was used to
confront these non-detects.
3. Results
3.1. Questionnaire data
All the participants reported to have eaten sh within the last
There were weak associations between maternal sh intake
and placental mercury concentrations for the study participants in
Kingston and St. Joseph. There was also a weak association be-
tween meHg ingested dose and placental mercury concentrations
for Kingston and St. Joseph. The average methylmercury ingested
dose was calculated as 0.07 mg/kg/d, body weight and 0.15 mg/kg/d,
body weight for participants in Kingston and St. Joseph,
respectively.
Since methylmercury exposure is primarily from sh intake, we
used Groth's methodology (Groth, 2010) to rank the total methyl-
mercury exposure based on sh preferences in each location. The
sum of methylmercury ingested dose by each participant was used
to determine the sh species that contributed to the overall
methylmercury exposure in the population. The main sh species
that contributed to overall methylmercury exposure in participants
from Kingston (Table 3) was cod (25%). While the main sh species
that contributed to overall methylmercury exposure in participants
from St. Joseph (Table 3) was shark (51%). Salmon (canned) and
Sardines (canned) contributed to the least methylmercury expo-
sure in the participants' diet.
 P. Ricketts et al. / Chemosphere 164 (2016) 462e468 465

Fig. 1. Most popular sh consumed by study participants from Kingston, Jamaica and St. Joseph in Trinidad, as determined through self-reported surveys at the time of pregnancy.

Table 2
Mean placental mercury concentrations, ingested dose and sh intake for participants in Kingston and St. Joseph.

Kingston St. Joseph

Mean SD Range Mean SD Range

Maternal Age (yrs) 29 6 19e48 26 5 17e42

Total sh intake per person/day (g) 38.5 43.4 2.0e151.0 20.9 21.8 3e42.5
MeHg ingested dose (mg/kg/day, bw) 0.07 0.09 0.001e0.64 0.15 0.22 0.01e0.94
Placental mercury concentration (mg/kg) ww 0.74 0.4 0.3e1.5 1.46 0.6 0.3e2.5

Table 3 given in Table 2. The mean placental mercury concentrations in

Evaluation of sh species and their fractional contribution to the overall methyl-
participants from St. Joseph (1.46 0.6 mg/kg) were found to be
mercury exposure to the sample population in Kingston and St. Joseph.
higher than in participants in Kingston (0.74 0.4 mg/kg). Fig. 2aeb
Common name Kingston St. Joseph showed that placental mercury concentrations in both groups were
Shark 0% 51% not evenly distributed. In the Kingston group placental mercury
Kingsh 0% 17% concentrations were skewed to the left, which may be due to the
Carite 0% 12% 48% of non-detects recorded (i.e. their concentrations were below
White grunt 9% 1%
Tuna-Bluen (canned) 18% 2%
0.5 mg/kg). All the placental mercury concentrations in St. Joseph
Yellowtail snapper 12% 0% group were above the method detection limit and fairly distributed
Sea Trout 2% 1% about the mean value. The 5% of participants in St. Joseph with the
Tuna-Albacore (fresh) 0% 3% highest placental mercury concentrations reported to eat shark,
Cod 25% 4%
cod, tuna, Carite, croaker at least once per month. The 5% of
Other 7% 3%
Shad 5% 0% participants from Kingston group, with the highest placental mer-
Croaker 0% 3% cury concentrations reported to eat cod and snapper at least once
Redtail snapper 6% 1% per month.
Tilapia 1% 0%
Mackerel-jack (canned) 9% 1%
Salmon-Pink (canned) 1% 0% 4. Discussion
Herring-Atlantic 1% 0%
Sardines (canned) 5% 0% 4.1. Caribbean sheries

The range for sh consumption per person is from 3 to 69 kg/yr.

3.3. Placental mercury biomarker data The average sh consumption per person in Jamaica was 16 kg/yr
and for Trinidad & Tobago it was 15 kg/yr (Masters, 2012). The sh
The mercury concentrations in placenta for both countries are consumption per person from the Kingston group may be calculated
466 P. Ricketts et al. / Chemosphere 164 (2016) 462e468
Fig. 2. a. Distribution of total mercury concentration (mg/kg) wet weight in placenta collected from participants in Kingston, Jamaica. b. Distribution of total mercury concentration
(mg/kg) wet weight in placenta collected from participants in St. Joseph, Trinidad.
as 14 kg/yr while in St. Joseph group, it would be calculated as
7.6 kg/yr. The selected participants in St. Joseph group may not be an
accurate representative of the population. The questionnaire data
showed that the study participants from Kingston (Jamaica) mainly
consumed reef nsh while those from St. Joseph (Trinidad &
Tobago) consumed large ocean pelagic sh. Studies have shown that
a sh's length inuences its mercury concentration (Jewett et al.,
2003; Gewurtz et al., 2011). Therefore exposure assessment of the
two groups was necessary. The sheries report in 2009, showed
where the large pelagic capture sh production in Trinidad &
Tobago was 5643 metric tonnes and none was captured in Jamaica.
Meanwhile, the shallow reef nsh capture productions were
12,500 and 52 metric tonnes, respectively for Jamaica and Trinidad
& Tobago (Masters, 2012). This is an indication that sh available for
consumption was primarily based on the country's yearly sh
capture production. The Captured sheries sector is divided into
marine, estuarine and riverine sheries (Kong, 2004). Countries
such as Trinidad & Tobago have few river, streams or lakes, suitable
for freshwater sheries system. Therefore the types of sh available
for consumption are mainly from ocean and sea (i.e. marine envi-
ronment). Meanwhile, sh available for consumption in countries
such as Jamaica, are both from inland freshwater systems and ma-
rine environment (Masters, 2012). It is projected to be an increase in
marine sh production in the Caribbean, therefore the health
benets and risk for sh consumption should be a concern for the
Region (Forde et al., 2014). There are many studies assessing dietary
sh intake and mercury exposure (Mahaffey et al., 2009; Wolkin
et al., 2012; Cheng et al., 2013). This dietary assessment method-
ology can be extended to other Caribbean Regional Fisheries
Mechanism member countries by adjusting the type of sh avail-
able for consumption in each country. There is a concern for other
Caribbean countries that consume sh more frequently and/or sh
containing high levels of mercury.
4.2. Methylmercury exposure
Results from survey responses showed that the median total sh
consumption from participants in Kingston was 2e3 times per
month and in St. Joseph it was found to be once per month. A
similar target group in Puerto Rico reported average maternal sh
consumption of 1e2 times per month (Ortiz-Roque and Lopez-
Rivera, 2004). The sh consumption of women of child bearing
age in Martin County, Florida was also found to be 1e2 times per
month (Nair et al., 2014). This indicates that the frequency of
maternal sh consumption is different in each country.
Although the total maternal sh intake per day for participants
in St. Joseph was lower than those in Kingston, the estimated
methylmercury ingested dose was calculated to be higher. This may
be due to the type of sh consumed. Monte Carlos simulations done
by Chien et al. showed that mercury concentrations in sh can
contribute up to 72% of daily mercury exposure dose (Chien et al.,
2007). Based on mercury exposure assessment of both groups in
this study, it was found that the participants who eat shark calcu-
lated the highest methylmercury ingested dose (~0.17 mg/kg/d,
body weight). Hence, there is a recommendation to develop sh
consumption advisories for populations that have continuous
abundance of various sh species. Risk communications should also
be improve so that pregnant women can choose to eat sh that
have low mercury concentration (Groth, 2010).
Pregnant women are advised to reduce consumption of
carnivorous or predatory sh due to health risk of mercury expo-
sure (Shao et al., 2011). The authors of a case study in Trinidad &
Tobago showed that consumers of sh only diets, consisting mainly
of shark and tuna, recorded elevated blood mercury levels up to
26.3 mg/L. Those authors also recommended the need to monitor
sh consumption and mercury levels in Trinidad & Tobago due to
the high availability of shark and tuna (Pinto Pereira and
Teelucksingh, 2009).
4.3. Placental mercury concentration
In this present study, the mean placental total mercury con-
centration was higher for the participants in St. Joseph
(1.46 0.6 mg/kg) than those in Kingston (0.74 0.5 mg/kg). There
 P. Ricketts et al. / Chemosphere 164 (2016) 462e468
are limited published results of placental mercury concentrations
in the Caribbean. However, these concentrations were still lower
than those reported in Taiwan (19 1.8 mg/kg) and Sweden
(median 1.8 mg/kg). Previous studies have also shown where the
placental mercury concentrations increases with an increase in
maternal sh consumption (Ask et al., 2002; Hsu et al., 2007). The
present study showed that there was a weak association between
placental mercury concentrations and maternal sh intake. How-
ever, the study in Hawaii that showed signicant difference in
placental mercury concentrations between those participants who
did not eat sh verses those who ate sh, also concluded that there
was no close correlation with sh intake and placental mercury
levels (Gilman et al., 2015).
4.4. Limitations
While the current study increases knowledge in a number of
areas and provides some initial data for which future studies can be
designed, there are some limitations worth mentioning. The sam-
ple size was not representative of the general pregnant women
population of each country. The study participants were selected
from teaching hospital situated in the capital cities, where maternal
sh intake may vary from rural or coastal communities. Further,
these individuals self-selected themselves to participate in this
work, and were thus not randomly sampled. There is a limited
database on mercury concentration levels in sh species caught in
the Caribbean. The mercury concentrations for coastal, shallow and
deep slope, reef nsh may vary in different countries due to
environmental pollution, and future studies are needed to better
establish a region-specic database of mercury levels in sh. The
type of questionnaire-survey used was limited as it depended on a
participant's recall of sh species consumed during the period of
interest. Another source of error is associated with the measure-
ment of mercury in the placenta. About 48% of non-detect were
reported for participants from the Kingston group, thus resulting in
some measurement error. The study also used one biomarker (i.e.
placenta) for prenatal mercury exposure but other biomarkers (e.g.
maternal hair or cord blood) could be collected in future works to
obtain a more complete understanding of exposure. Nonetheless,
despite these limitations the current work lays the foundation for
future-planned research that will employ more detailed surveys of
seafood consumption and mercury exposure assessments in a
number of countries in the Caribbean region.
5. Conclusion
The purpose of the study was to assess the dietary patterns of
sh consumption for pregnant women from Kingston in Jamaica
and St. Joseph in Trinidad & Tobago, and prenatal mercury expo-
sure, by using the placenta as a biomarker. Based on the weak as-
sociations obtained, the study concluded that placental mercury
concentrations were a weak predictor of mercury exposure from
maternal sh intake. Research on the transplacental transfer of
mercury should be further developed because of the wealth of in-
formation that can be obtained from the placenta. The sh prefer-
ence for each population was dependent on the local sheries
mechanisms. Participants living in countries that mainly consume
shallow water reef sh reported lower placental mercury concen-
trations, than those living in countries that mainly consume ocean
pelagic sh. It was found that the methylmercury ingested dose for
most participants was below the US EPA and EFSA ingested refer-
ence doses. However the reported ingested dose for participants
from St. Joseph was more than 50% higher. This may possibly be due
to high mercury exposure from eating shark. This type of research is
very timely given that most governments, including Jamaica, have
467
recognized this by adopting the UN Minamata Convention on
Mercury Pollution which ultimately aims to protect human and
ecosystem health from mercury (UNEP, 2013; Gustin et al., 2016).
Acknowledgements
This research project was funded by a Research and Publication
award granted by the Ofce of Graduate Studies and Research at the
University of the West Indies, Mona.
Collaboration with McGill University was made possible by
funding from the Government of Canada, under the Canada- CAR-
ICOM leadership scholarship programme. Mercury analyses were
funded by a National Sciences and Engineering Research Council
(NSERC) Canada Discovery Grant and Canada Research Chair (CRC)
to Niladri Basu.
Ethical approval was granted by the Ethics Committee of the
Faculty of Medical Sciences at the University of the West Indies,
Mona and St. Augustine campuses.
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