Screening for Mercury Levels in the Perinatal Population

Abstract

What to ingest during pregnancy and while breastfeeding is always a priority topic (Food and Drug Administration, 2021). Northwestern Ontario (NWO) is home to beautiful terrain, including streams, rivers, and lakes which can provide nourishment to those living around them (Government of Canada, 2021). However, the nourishment provided by such areas, such as fish, contain certain naturally occurring levels of mercury that are then ingested (Food and Drug Administration, 2021). Northern communities are more at risk of elevated mercury levels due to the higher reliability of fish as a nutritional source and the ecosystems that they are within (Fournier, Karachiwalla, & Shah, 2021). Long-term mercury exposure can cause damage to the liver and kidneys (Fournier, Karachiwalla, & Shah, 2021). Given the fact that eating fish also has tremendous benefits (Taylor et al., 2022) and the idea of not eating fish is implausible, especially in certain cultures, the healthcare system needs to look at high mercury level prevention in vulnerable individuals. The descriptive study looked at how often primary care providers (PCPs) (family physicians, midwives, and nurse practitioners) screened for elevated mercury levels in their patients. The study took place in NWO from June 1st, 2023, to October 1st, 2023, using Qualtrics. It was found that 58% of PCPs either never ask their patients about fish consumption or sometimes ask about fish consumption and 86% have never ordered a blood mercury level on their perinatal patients. Barriers to such screening include it not coming up in conversation, language, not appearing to be worth discussing, having no guidelines, lack of knowledge, and unsure if fish consumption is relevant to discuss. The participants requested a screening pathway, more accessible means of fish consumption guides, and education seminars. These recommendations can assist PCPs in screening for mercury more efficiently in their patient population.