Objectives: To assess the efficacy of a public health intervention to reduce blood mercury (Hg) concentration levels in pregnant Bermudian women.Methods: In 2003, we conducted a study entitled "Prenatal exposure of the Bermudian Population to Environmental Contaminants" which provided Bermuda's first baseline data on prenatal exposure to several environmental contaminants, including Hg. The mean Hg concentration from 42 healthy newborns measured in umbilical cord blood was 41.3 nmol/L, ranging from 5-160 nmol/L. This concentration was much higher than expected, being approximately 8 times the general levels found in Canada and the U. S. Furthermore, we estimated that 85% of total Hg measured was in the form of methylmercury (MeHg), indicating that seafood consumption was the primary source of Hg exposure during pregnancy in Bermuda. Locally sourced seafood was identified as the most significant possible contributory source of Hg exposure. In 2005 the authors began a complementary research programme to study the levels of Hg in local commercial fish species. Coming out of this research were specific local fish consumption guidelines issued by the Department of Health advising pregnant women to avoid those local fish species found to be high in Hg while still encouraging consumption of fish species having lower Hg levels.Results: In 2010, under another research initiative, we returned to Bermuda to carry out another evaluation of Hg in human blood. Hg was measured in the blood of 49 pregnant women. The arithmetic mean Hg blood concentration was 6.6 nmol/L and the geometric mean 4.2 nmol/L. The maximum concentration found was 24 nmol/L.Conclusions: Hg exposure of Bermudian pregnant women has dropped significantly by a factor of around 5 since the foetal cord blood study in 2003.

We report three historical cases of severe vitamin A intoxication in anglers who had consumed reef fish liver caught in Bermuda. The subsequent analyses of 35 fish livers from seven different fish species revealed that very high concentrations of vitamin A exist in tropical fish liver, even in noncarnivorous fish species. Large variations in concentrations were observed between specimens and between species. The angling population and (especially) pregnant women should be advised of this potential health threat.

Objective: To describe cancer and mortality rates in Bermuda and to compare such rates to those of the United States of America (USA). Methods: Age-adjusted race-specific cancer incidence rates for Bermuda were calculated using the Bermuda Cancer Registry. These rates were then compared to USA cancer rates published by the National Cancer Institute. Results: Overall age-adjusted incidence rate was 495 cases per 100 000 for Blacks and 527 cases per 100 000 for Whites. Incident cases were more frequent among men than women in both races. For Blacks, the highest incidences were prostate for men and breast for women, followed by colon/rectum and lung cancer. For Whites, if we exclude benign skin cancers, the picture was similar with the notable exception of lung cancer being more frequent than colon/rectum in White males. When Bermuda’s rates were compared to those of the USA, overall cancer rates were similar in both countries. Rates in Bermuda were higher for cancer of the mouth, ovarian cancer (Black women), melanoma (Whites), colorectal cancer (White women) and breast cancer (White women). Lung and colorectal cancers were less frequent in Bermuda’s Black population. Conclusion: Further epidemiological studies are needed to identify potential risk factors that could contribute to these differences. Screening and prevention strategies could be adjusted accordingly. Incidencia del Cáncer y Tasas de Mortalidad en Bermuda F Dallaire1, E Dewailly1, P Rouja2

“Figure 1”. Sigannus Linneatus from One Arm Point displaying fat deposits on intestine. The results of the research were published in 2003 and supported the wisdom of Bardi fishermen. Their seasonal fishing patterns, moving from species to species based on their relative fatness and focusing and isolating fat deposits in the gut of fish, secures for them an important source of omega three fatty acids.

B. Worm et al. (“Rebuilding Global Fisheries,” Research Articles, 31 July, p. [578][1]) reported cases in which effective fisheries management was based on catch restriction, gear modification, and closed areas. Consumers can also play a role in the future of fisheries. The demand for fish continues to increase yearly—is it possible to maintain the benefits of fish consumption while minimizing the risks to both human health and global fisheries? ![Figure][2] Sardines. Small pelagic fish such as sardines contain more nutrients and fewer contaminants than larger types of fish. CREDIT: [ISTOCKPHOTOS.COM][3] Harvesting from higher trophic levels in the marine food chain eventually leads us to make nutritionally and ecologically incompetent choices. We are eating the wrong kinds of fish and too many of them. There is good indication that some of the smaller fish species have more to offer to human health with less risk than larger fish closer to the top of the food chain. There are several reasons for this. Fish at the top of the food chain can become significant repositories for a range of contaminants both natural and anthropogenic and may also have low concentrations of key nutrients. The flesh of most large predator fish from warm water fisheries (big tuna, swordfish, marlin, shark) usually is low in omega-3 fatty acids and high in mercury/selenium ratios ([ 1 ][4]). Small pelagic fish, such as sardines, herrings, anchovies, and mackerel, however, have not been subject to the same overfishing pressure that has befallen almost all of the larger fish species. They not only provide higher levels of beneficial nutrients but are also significantly lower in contaminants ubiquitous to the marine food chain. They are also very affordable. Consumers' choices are more and more influenced by health and environmental considerations. That could make a difference. 1. [↵][5]1. E. Dewailly 2. et al ., Food Add. Contam. 25, 1328 (2008). [OpenUrl][6][CrossRef][7] [1]: /lookup/doi/10.1126/science.1173146 [2]: pending:yes [3]: http://ISTOCKPHOTOS.COM [4]: #ref-1 [5]: #xref-ref-1-1 "View reference 1 in text" [6]: {openurl}?query=rft.jtitle%253DFood%2BAdd.%2BContam.%26rft.volume%253D25%26rft.spage%253D1328%26rft_id%253Dinfo%253Adoi%252F10.1080%252F02652030802175285%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [7]: /lookup/external-ref?access_num=10.1080/02652030802175285&link_type=DOI

OBJECTIVE:To describe cancer and mortality rates in Bermuda and to compare such rates to those of the United States of America (U.S.A.).METHODS:Age-adjusted race-specific cancer incidence rates for Bermuda were calculated using the Bermuda Cancer Registry. These rates were then compared to U.S.A. cancer rates published by the National Cancer Institute.RESULTS:Overall age-adjusted incidence rate was 495 cases per 100,000 for Blacks and 527 cases per 100,000 for Whites. Incident cases were more frequent among men than women in both races. For Blacks, the highest incidences were prostate for men and breast for women, followed by colon/rectum and lung cancer. For Whites, if we exclude benign skin cancers, the picture was similar with the notable exception of lung cancer being more frequent than colon/rectum in White males. When Bermuda's rates were compared to those of the U.S.A., overall cancer rates were similar in both countries. Rates in Bermuda were higher for cancer of the mouth, ovarian cancer (Black women), melanoma (Whites), colorectal cancer (White women) and breast cancer (White women). Lung and colorectal cancers were less frequent in Bermuda's Black population.CONCLUSION:Further epidemiological studies are needed to identify potential risk factors that could contribute to these differences. Screening and prevention strategies could be adjusted accordingly.

Bermuda residents collect rainwater from rooftops to fulfil their freshwater needs. The objective of this study was to assess the microbiological quality of drinking water in household tanks throughout Bermuda. The tanks surveyed were selected randomly from the electoral register. Governmental officers visited the selected household (n = 102) to collect water samples and administer a short questionnaire about the tank characteristics, the residents' habits in terms of water use, and general information on the water collecting system and its maintenance. At the same time, water samples were collected for analysis and total coliforms and Escherichia coli were determined by 2 methods (membrane filtration and culture on chromogenic media, Colilert kit). Results from the 2 methods were highly correlated and showed that approximately 90% of the samples analysed were contaminated with total coliforms in concentrations exceeding 10 CFU/100 mL, and approximately 66% of samples showed contamination with E. coli. Tank cleaning in the year prior to sampling seems to protect against water contamination. If rainwater collection from roofs is the most efficient mean for providing freshwater to Bermudians, it must not be considered a source of high quality drinking water because of the high levels of microbial contamination.

Fish consumption today is widely recognized as highly beneficial since it constitutes a good source of several essential nutrients, such as selenium and polyunsaturated fatty acids (n-3 PUFA). However, fish can also contain contaminants such as mercury, which make the consumer, especially pregnant women, confused about the risk–benefit balance associated with fish consumption. This is particularly true for tropical fish species for which little information is available. We have previously reported that some Bermudian neonates had elevated mercury in their umbilical blood compared with international guidelines. The objective of this study was to give precise and balanced information on the content of mercury, selenium and PUFA in the most consumed fish species in Bermuda. In 2003 and 2006, a total of 307 fish were collected from 43 fish species and 351 samples were analysed (305 flesh samples, 44 liver samples, one roe and one fat sample) by inductively coupled plasma-mass spectrometry (ICP-MS) (metals) and high-resolution gas chromatography (HRGC) (fatty acids). Results show that mercury varies among species from 0.03 to 3.3 µg g−1 and that it is possible for at-risk groups such as pregnant women to make informed choices concerning fish consumption, e.g. maximizing fish species rich in nutrients and low in mercury.