Chapter 10
Discussion on
human health effects

10.1. Main findings of health importance
Chapter 10
It is likely that DDT and HCH blood contamination
10.1. Main findings of health importance
largely originate from common exposure sources
The representative survey groups from indigenous
which are not closely associated with the contamina-
populations in each of the study areas, including 255
tion of natural areas or wildlife. Based on the results of
mother-child pairs and 1576 adults, have provided
the targeted survey, extensive uncontrolled household
comprehensive data on gender, age, place of resi-
use of materials which contain lead, and also use of
dence, the nature of traditional activities undertaken,
insecticides and pesticides for rodent control, may sig-
diet, life-style details, self-evaluated health status and
nificantly contribute to human PTS loads, through the
family health history. In addition, this database is sup-
secondary contamination of food which is stored and
ported by reliable medical information, obtained from
processed at home.
personal medical records held by local hospitals and
measurements of blood levels of all major PTSs. All of
From the survey, it was found that in randomly selected
which information, helps to suggest that the study pop-
wash-outs and wall scrapes taken from 28 houses occu-
ulations used in this report adequately reflect the gen-
pied by indigenous families in the Nenets, Taymir and
eral conditions characteristic of the indigenous popu-
Chukchi Autonomous Okrugs, all major POPs were
lation of the Russia Arctic as a whole.
detected in 100% of cases. Levels were highest in
Chukchi samples, where HCH was over 4 ľg/m2 and
Blood PTS concentrations show that all indigenous
DDT was up to 4500 ľg/m2. Taymir wash-outs con-
communities residing in the areas of the Russian
tained up to 38 ľg/m2 of total PCBs. DDE and DDD
Arctic studied, have suffered moderate exposure to
metabolites in the wash-outs and scrapes constituted
the major groups of global environmental pollutants
27% of total DDTs on average, (within a range of 10-
known to be transmitted through food chains, such as
70%), which suggests significant recent indoor con-
PCBs, DDT, HCH, HCB, lead and mercury. Only lead
tamination by chemicals containing DDT.
concentrations in blood, however, were found to
exceed the threshold level currently recommended by
Between 65 % and 100% of home-made local foods,
WHO (100 ľg/L) and then only in some cases. The
including both food which is prepared for cooking in
main sources of lead exposure in the arctic are
the kitchen (i.e. trimmed and sliced) and ready-to-eat
assumed to be the contamination of local food
foodstuffs (salted, boiled or fermented) were contami-
through both long-range transport of lead and the
nated by PCBs and DDT. Furthermore, 12 out of 13
uncontrolled use of materials containing lead, such as
domestic food samples from the Nenets AO communi-
paints and homemade ammunition (from pellet and
ties, were contaminated by DDT at levels exceeding
bullet casting).
national food safety limits, while reindeer meat and
fish samples taken from the natural environment at
Actual serum concentrations of total PCBs (Arochlor
these locations were not found to be excessively con-
1260) were frequently found at levels of 5-8 ľg/L.
taminated by POPs. Data obtained during targeted sur-
Regardless of the fact that national guideline levels for
veys indicate that levels of indoor PCB contamination
these toxic substances in blood have not been estab-
(of walls, kitchen facilities and appliances) correlate
lished, this may still be considered as a matter of con-
well to PCB levels measured in the blood of indigenous
cern for human health. Recent evidence suggests that
people living in houses surveyed. It is believed that
PCBs may cause adverse reproductive, developmental,
intake of these substances by family members from the
and endocrine effects (ATSDR, 2003, June Update).
indoor environment takes place through the secondary
Despite the manufacture of PCBs being banned in
contamination of food.
most Arctic countries since 1977 (since the early 1990s
in Russia), a number of current exposure sources do
Based on concentrations measured in maternal
remain. It is well documented that the greatest human
blood serum, exposure of Russian Arctic indigenous
exposure to PCBs occurs through the consumption of
peoples to PTS, and specifically to HCHs, HCB, DDT
contaminated fish. It is likely that PCB congeners are
and PCBs, is one of the highest reported for all Arctic
capable of being released into the general environ-
regions. The discovery of up to a 25-fold increase in
ment and thus, are able to contaminate local food by
p,p'-DDT serum concentrations in women from all of
means of poorly maintained toxic waste sites, contami-
the study areas, may indicate a fresh source of expo-
nated dwellings and through the unacceptably poor
sure, bearing in mind that DDE concentrations of
sanitation systems found in most native communities
the women are at level comparable to other arctic
in the Russian Arctic.
populations (Hansen et al., 2000; J. Oostdam et al,
1999).
As seen from concentrations of contaminants meas-
ured in maternal blood serum, indigenous pregnant
The POP exposure intensity (body burden) of arctic
women living in coastal areas of the Russian Arctic,
indigenous women as measured in maternal and
show levels of exposure to a group of 'long-banned'
umbilical serum, in some cases exceeds that of resi-
pollutants, and in particular to HCB, DDT and PCBs,
dents of territories which are internationally recog-
that are among the highest currently reported for all
nized as disaster areas, for example the Aral Sea
Arctic indigenous peoples (AMAP, 1997 and 2002).
region. Here, due to long-term application of persist-
178

Chapter 10
10.1. Main findings of health importance
ent pesticides, very high levels of environmental pol-
Low-income indigenous families are at greater risk of
lution exist, particularly for DDT and HCH (Muntean
exposure to POPs due to their significantly higher con-
et al., 2003), which occur in local foods at levels high-
sumption of local foods, particularly fish and marine
er than maximum residue limits established by
mammals of high fat content, which in many cases act
European Commission (EC, 1997, 1999, 2003). Thus,
as a major source of human exposure to environmental
the geometric means of cord and maternal ľ-HCH
toxicants. Women with low incomes residing in the
concentrations in the Chukotka population were
Chukchi AO, are also more likely than women with
found at levels 10-20% higher than those measured in
high incomes to be either underweight or obese. The
Aral Sea women. DDE cord concentrations in the
prevalence of adverse outcomes of pregnancy increases
Kola population occur within ranges similar to those
steadily with a reduction in family monetary income
found in the Aral Sea population, while maternal and
per capita.
cord HCB concentrations measured in the coastal
population of Chukotka, are likely to be some of the
As a rule, blood concentrations of organic contami-
highest ever reported for both the Arctic and Aral Sea
nants are positively correlated with each other, while
regions.
this is not the case for inorganic contamnants. In
pregnant women, a closer relationship is found
As some pesticides such as Mirex and toxaphenes have
between total PCBs and HCB (neither of which are
never been manufactured or imported into Russia (or
pesticides), which presumes a common exposure
into the former Soviet Union), blood serum concen-
source. Those organochlorines which are classified as
tration levels in the indigenous population in the study
pesticides, are also positively correlated with each
areas, provide an opportunity to obtain an approxi-
other.
mate evaluation of the relative contribution made by
global transfer of these substances to the POP expo-
Significantly higher blood concentrations of PTS are
sure experienced by indigenous populations residing
found in males of indigenous populations compared
in the study area (Figure 10.1).
to females. At a community level, the lowest serum con-
centrations of POPs are found in pregnant women,
Given the results for Mirex in Table 10.1, it is assumed
probably due to early hospitalization in delivery depart-
that most of the study populations in arctic Russia are
ments (and thus a change to a very different nutrition
exposed to levels of long-range transported persistent
pattern). Long-term hospitalization preceding the
toxicants which are from 4 to 100 times less than the
expected birth is a common practice in prenatal health
population resident in the coastal area of the Chukotka
care in remote Russian Arctic areas.
Peninsula.
At variance with commonly accepted views, cord blood
concentrations of Pb and total Hg were frequently
found to be higher than those measured in maternal
blood and are poorly correlated. It is possible there-
fore, that babies could be at greater risk from inorgan-
ic pollutants accumulated by their mothers. In con-
trast, concentrations of total PCBs and most pesticides
measured in maternal serum (expressed as unit of mass
per unit of volume) are significantly higher when com-
pared to their concentrations in cord blood and are
closely correlated.
POP concentrations measured in blood serum are
highly dependent on age. This phenomenon may
reflect the impact of past exposure to POPs which, it is
Table 10.1. Serum concentrations of Mirex in study populations.
assumed, was much greater everywhere in the Arctic
n.d. not detected
(AMAP, 1997).
Figure 10.1
1. Chukotka coastal
Proportion of serum samples
2. Chukotka inland
containing Toxaphenes and
3. Kola
Mirex in the study popula
4. Pechora
tions, %
5. Taimyr
179

10.2. Region specific priorities for environmental health
Chapter 10
The number of breast fed children has been also found
In contrast to information previously obtained from
to be a significant determinant of POP serum concen-
national and global statistics, female babies of indige-
trations in women. Serum concentrations of lipophilic
nous mothers with elevated POP blood concentra-
contaminants is reduced by an increase in parity.
tions, are exposed to a higher risk of low birth weight
and other adverse outcomes of pregnancy when com-
In formal terms, only blood mean PCB and lead con-
pared to male babies. A similar association was report-
centrations in the adult indigenous population
ed for a number of cases where parents had been
exceed the internationally recognized levels of con-
exposed to organochlorine chemicals.
cern, designed to evoke preventive action. However,
statistically significant associations have been found
between blood concentrations of total PCBs (Arochlor
1260) and lead and a number of non-specific repro-
ductive and developmental health effects such as
prevalence of low birth weight, premature births, still-
births and major structural malformations (Tables
10.2 and 10.3).
Also, statistical analysis of recorded health problems in
connection with blood concentrations of some other
pollutants (Hg, Cd and HCHs) indicates possible associ-
ations between pollutant levels and the prevalence of
certain reproductive and developmental stages as well as
with the prevalence of chronic diseases in older people.
Serum concentrations of total PCBs in maternal blood
appear to be associated with alterations to the sex ratio.
For concentrations of between 2 to 4 ľg/L, the fre-
quency of male offspring is found to be higher than the
national average. In contrast, for maternal total PCB
Table 10.3. Summary of possible health effects associated with exposure
blood concentrations higher than 4.0 ľg/L, there
of pregnant indigenous women to PCB.
appears to be a strong effect on the prevalence in
female offspring. Such a phenomenon has been widely
Any criteria proposed for the limitation of POPs in
discussed elsewhere in terms of paternal exposure to
human blood and tissues necessarily involve a large num-
dioxin and dioxin-like substances (Davis et al. 1998;
ber of uncertainties, due to the lack of precise toxicolog-
Ryan et al, 2002). Given that close correlations among
ical information on the effects of hazardous substances,
adult members of a family are seen in blood levels of
especially when addressing the most sensitive sub-groups
PCBs (see chapter 6) the exposure of fathers (as well as
of people (e.g, infants, the elderly and the majority of
mothers) cannot be ruled out as a possible important
indigenous people who lack good nutritional) .
risk factor in affecting sex ratios.
10.2. Region specific priorities
for environmental health
A summary of regional environmental health priorities
related to the project objectives is given in Table 10.4.
10.3. Evidence of causation
Because causation is a fundamental issue in the epi-
demiology of reproductive health and developmental
disorders, the lines of evidence described in Table 10.2
need further discussion. To show that a causal relation-
ship does exist, a number of tests or criteria have been
developed (Hill, 1965; Wynne and Braunwald, 1998;
Cotran et al., 1999). These include consistency of
results between studies involving different groups; the
way in which the results of different studies fit each
other (coherence); whether there is a relationship
between given definite levels of exposure and the effect
or population response ('dose-response relationships')
etc. Since very limited information on PTS-induced
human reproductive and developmental effects is avail-
Table 10.2. Summary of possible health effects in indigenous populations
able, it is not feasible to test the full set of suggested
associated with exposure of indigenous people to selected metals.
epidemiological criteria of causation.
180

Chapter 10
10.3. Evidence of causation
After adjustment for major confounders (i.e, smok-
ing and alcohol consumption) the increased risk of
adverse outcomes of pregnancies was clearly observ-
able for concentrations of total PCBs in maternal
serum over 2.0 ľg/L, which is significantly lower
than the level recommended as a level of concern (5-
20 ľg/L) and much lower than the level of effects
(100 ľg/L). The same is broadly true in terms of
maternal lead concentrations, for which typical
developmental disorders in newborns were manifest
at levels of 30 ľg/L, when internationally recom-
mended guidelines are currently set at 100 ľg/L.
There are, however, two possible factors to be con-
sidered which are capable of affecting developmental
disorders associated with PTS exposure. A first and
frequently mentioned circumstance, is that the
indigenous people of the Russian North are general-
ly considered to be one of the most susceptible sub-
populations due to factors such as malnutrition and
an altered traditional diet that has become physio-
logically inadequate (Panin, 1989). A second uncer-
tainty is that an adverse pregnancy outcome may not
be solely the result of maternal exposure. Paternal
exposure may also transfer risks to the off-spring.
The study design used, however, did not allow the
quantification of such risks.
Table 10.4. Priority problems for different study regions
The new evidences obtained suggest that the associa-
in the Russian Arctic. 1 at least one of PTS occurring in concentrations above the
tion between environmental exposure to PCBs, lead
national limits; 2 contaminants either occasionally exceeding international guidelines
and mercury (as measured by blood levels which are
(level of concern) or are shown to associate with a certain effect
considered to be relatively common for indigenous
In the meantime, the identification of 38 cases in
populations of the Russian Arctic) and health effects
which the outcome of pregnancy was fatal, 62 cases of
such as the prevalence of low birth weight, reduced ges-
reduced birth weight (16 of which were extremely low),
tational age, fatal outcomes of pregnancy and the
27 cases of premature birth, 8 cases of serious birth
prevalence of chronic diseases in women, supports a
defects and 31 spontaneous abortions, supported by
hypothesis of causation.
life-style, occupational and other information on risk
factors, as well as the measurement of a wide range of
Statistical associations for the observed effects may be
PTS in the environment, food, indoor materials and
further improved by analysis of the remaining blood
blood specimens collected as part of the cross-section-
samples taken during the surveys, which are currently
al study presented in this report, provides an opportu-
deep frozen (within the framework of the project, only
nity to consider the causal role of exposure of individ-
255 of the 348 maternal blood samples collected were
uals to specific environmental contaminants.
randomly selected and analyzed). In a preliminary
check of the 93 remaining sample donors, it was found
Current evidence supporting the classical causation
that they include mothers recorded as having 14 cases
indicators of plausability, consistency, coherence and
of adverse pregnancy outcomes.
analogy is judged to be acceptable for PCBs (Table
10.4), as well as for lead and total mercury exposures,
10.4. Application of the precautionary principle
as measured in human blood. It is not possible to
Even though the lines of evidence for the causal role
properly assess the temporality and/or reversibility of
of PTS with respect to health effects are generally
previously reported findings, because the health
not complete and there are a number of uncertain-
effects suggested as being associated with PCB expo-
ties to accommodate before establishing reliable
sure, constituted limited population-based reports and
causation, it is important to note that the anticipat-
were not the outcome of a systematic epidemiological
ed health effects associated with PTS exposure as
study. However, it should be noted that the inherent
experienced by vulnerable groups of indigenous
weakness of cross-sectional study design and the limit-
populations are likely to be serious, and include
ed number of pregnant women available for survey
birth defects and fatal outcomes of pregnancy. For
purposes (i.e. low power) diminishes the impact of the
this reason, it is suggested that two approaches are
elevated relative risks and statistically significant p-
taken in addressing these uncertainties when con-
values of the Chi-Square Test and of Fisher's Test pre-
sidering recommendations and planning public
sented in Table 10.2.
health action.
181

10.4. Application of the precautionary principle
Chapter 10

Table 10.5. Rules of causation applied to the prevalence of low birth weight and reduced gestational age of newborns in arctic indigenous women; experience
of higher environmental exposure to PCBs is definite, with maternal serum concentrations exceeding 2.0 ľg/L (or 300ng/g lipids).
From the project perspective, it is believed that a precau-
B. When concern arises about an existing regulation
tionary principle (PP) which addresses the avoidance of
in the light of new evidence of an adverse effect
potential harm, should be applied in two basic situations
becoming available.
encountered in the environment or workplace.
A number of basic factors or criteria associated with
A. When there is a lack of regulation and lack of
the application of the PP have gained both national
human data, but sufficient animal data.
and international requirements:
182

Chapter 10
10.4. Application of the precautionary principle
1. The size of the population affected;
8. The need to apply PP on a case-by-case basis; a
2. The higher susceptibility of certain subgroups
single conceptional framework not necessarily
(e.g. children, pregnant women, individuals
being suited to all situations;
with poor health or malnutrition);
9. When failure to apply precautions may engen-
3. The seriousness of the anticipated effects (e.g.
der liability in the future.
irreparable or irreversible impairments which
The establishment of exposure limits in Russia, consti-
significantly compromise human health);
tutes, in many cases, an application of the precaution-
4. The transparency and disclosure of potential
ary principle. However, in the absence of such limits
risks (`right to know' of the public);
and guidelines for blood concentrations of PTS and
5. The consideration of inputs other than scientif-
also of limits for foodstuffs, it is clear that the potential
ic evidence (e.g. a high level of public anxiety);
seriousness of the anticipated effects and their general
6. The implementation of temporary precaution-
consistency with current knowledge regarding the spe-
ary exposure levels;
cific toxicity of the PTS in question, argues for the
7. The implementation of interim measures to
application of the precautionary principle (at least on a
reduce exposure to levels as low as possible/rea-
'case-by-case' basis) as some babies may be at excessive
sonable;
risk from pollutants taken up by their mothers.
183

Overall conclusions and recommendations
ment and implementation of the Arctic Council
Overall conclusions and recommendations
Action Plan to eliminate pollution in the Arctic are
good, but not the only, indicators of attaining rele-
The main conclusion of the first AMAP assessment
vant project objectives.
(AMAP, 1997) clearly stated that the well-known bene-
fits of breast milk and traditional food definitely out-
3. The existing system in Russia for statistical report-
weighed the risks to human health risks from contami-
ing of environmental releases do not cover most
nants. The social, cultural, spiritual and physical
persistent toxic substances, and in particular, those
health of Arctic indigenous peoples, depends on the
covered by the Stockholm Convention on Persistent
collection and consumption of country foods. The con-
Organic Pollutants.
sumption of local fish, meat, wild greens and berries is
In this respect, it is recommended that new forms of state
important in providing the necessary dietary intake of
statistical reports on industrial atmospheric emissions,
most nutrients, vitamins, essential elements and min-
waste water discharges and solid wastes, be developed and
erals. Based on these conclusions, the AMAP assess-
approved, which should be adequate for the requirements of
ment recommended that:
the Stockholm Convention on Persistent Organic
Pollutants and other international treaties and agreements
ˇ
Consumption of traditional food continues, with
aimed at the limitation of environmental and human
recognition that there is a need for dietary advice to
health effects of persistent toxic substances. In this, it is rec-
Arctic peoples so they can make informed choices
ommended that experience gained in the development and
concerning the foods they eat;
use of registers for emissions of contaminants and trans-
ˇ
Breast milk should continue to be promoted.
port be used.
These basic conclusions and recommendations have
4. From experience gained during project implemen-
received full acknowledgement and support within the
tation, existing data and information on PTS pollu-
framework of this project. At the same time, a number
tion sources available to federal and local environ-
of important findings made during the period of proj-
mental and human health authorities does not
ect implementation have promoted the development
adequately reflect the actual situation in the
of conclusions and recommendations specific for
Russian Arctic regions. Studies and surveys within
Arctic Russia, and for the objectives of the project.
the project framework have documented the envi-
ronmental impact of unknown local PTS sources. In
1. A close partnership has been successfully achieved
particular, there is evidence of relatively fresh envi-
between researchers and indigenous organizations
ronmental releases of contaminants such as DDT
and communities in accordance with international-
and PCB.
ly recognized practices, as well as effective co-opera-
Taking into account the objectives aimed at implementa-
tion in developing remedial actions to reduce
tion of the Environmental Doctrine of the Russian
health risks resulting from the contamination of the
Federation and the Fundamentals of the State Policy in
environment and traditional food sources. The
Chemical Safety, it is recommended that a source inventory
project has been implemented with the active par-
system be developed and implemented in the Arctic admin-
ticipation of the Russian Association of the
istrative territories inhabited by the indigenous peoples, that
Indigenous Peoples of the North, Siberia and Far
covers both former and current releases of PTS from all eco-
East (RAIPON) and its regional branches. RAIPON
nomic activities.
representatives acted as equal partners with the sci-
entific teams in all project activities and phases,
5. PCBs can be considered as one of the most serious
including the development of project recommen-
environmental and human health risk factors for
dations. Achieving the project objectives would not
the areas covered by the project , which cannot be
have been possible without close collaboration with
adequately explained by long-range transport and
the Russian executive authorities, and particularly
existing information on local sources. According to
the administrations of the regions where the project
the Russian PCB inventory, 53,000 out of 180,000
was undertaken.
tonnes of PCB produced in the former USSR, were
used for the production of paints, varnish, lubri-
2. Project implementation has enhanced the position
cants and other products, i.e, they have been used
of the Russian Federation in international negotia-
in open systems. Although this type of PCB use
tions to reduce the use of PTS, and empowered
could not be taken into account by the inventory, it
RAIPON to participate actively and fully in these
is likely that some of the PCB- related problems
negotiations. The signing of the Stockholm
mentioned above also resulted from contamination
Convention on Persistent Organic Pollutants by the
from such sources.
Russian Federation, the active role played by
Within the framework of the Russian National Action
RAIPON, in line with other International
Plan on implementation of the Stockholm Convention, it is
Organizations of the Arctic Indigenous Peoples,
recommended that a special section on the rehabilitation
and the full-scale participation of Russian federal
of PCB-contaminated sites, including land and housing be
executive agencies and RAIPON in the develop-
developed and implemented. With respect to this issue, spe-
184

Overall conclusions and recommendations
cial attention should be paid to land and settlements inhab-
As a follow-up to this project, it is recommended that the
ited by Arctic indigenous peoples, taking into account their
Russian federal executive human health and environmen-
lifestyle and social vulnerability.
tal authorities, in close collaboration with the Russian
Association of Indigenous Peoples of the North, Siberia
6. A significant proportion of total global PTS in the
and Far East and regional and local administrations,
Arctic environment, is determined by their long-
develop a set of practical activities aimed at achieving, in
range transport. For example, the pesticide, Mirex
full acknowledgement and respect of the traditional
has not been produced and used in either the USSR
lifestyle and cultural identity of the Russian Arctic indige-
orRussia. However, levels of Mirex in the blood of
nous peoples, a significant reduction in their PTS intake.
the indigenous population residing in the Russian
These measures, which should be an integral part of the
Arctic, particularly in coastal Chukotka, are found
National Plan of Social and Economic Development of the
at clearly detectable levels, albeit lower than in
Russian Northern Territories, should include actions
some other parts of the Arctic, such as Arctic
required at the federal, regional and local levels, taking
Canada. At the same time, the validity of long-range
into account the circumstances of each area. More specific
atmospheric transport and deposition estimates is
regionally-based recommendations, addressed to the indige-
limited by the scarcity of data on remote sources,
nous peoples should be presented in special publications in
and a lack of comprehensive source inventories.
Russian.
It is recommended that the Government of the Russian
Federation, in cooperation with the other member countries
9. The levels of human exposure to PTS in the Russian
of the Arctic Council, take active measures in the interna-
Arctic, specifically to HCB and HCH, and, in some
tional arena to ensure the reduction, and in the future, the
cases, also to DDT and PCB, is one of the highest
full elimination of environmental and human health
reported for all of the Arctic regions. In some cases,
threats from global PTS. In particular, it is recommended
exposure has been shown to exceed levels assessed
that the Russian Federation ratifies the Stockholm
for residents of territories, which are international-
Convention on Persistent Organic Pollutants, and joins
ly recognised as disaster areas, such as the Aral Sea
the Aarhus Persistent Organic Pollutants and Heavy
region, due to long-term use of persistent pesti-
Metals Protocols of the UN-ECE Convention on Long-
cides. In the areas of the Russian Arctic studied,
range Transboundary Air Pollution.
practically every indigenous family consumes a sig-
nificant amount of traditional food. Families with
7. Environmental aspects of human health, particular-
low incomes rely to a greater extent on the local, fat-
ly those associated with PTS exposure of indigenous
rich traditional diet. As a consequence, low-income
peoples, are closely linked to the economic and
indigenous families are at greater risk of exposure
social status of indigenous families. In this respect,
to POPs.
a significant reduction in the effects of PTS on
It is recommended that the human health authorities and
human health cannot be successfully achieved with-
administrations of the territories of the Russian Arctic
out improvement in the economic and social con-
inhabited by indigenous peoples, in close collaboration with
ditions of the Russian Arctic indigenous peoples.
the regional branches of RAIPON and in full acknowl-
It is recommended that, the National Plan of Economic and
edgement of the importance of the traditional diet for nutri-
Social Development of the Northern Territories of the
tion and preservation of the national and cultural identity
Russian Federation, which, it is envisaged, is to be developed
of the indigenous peoples, as part of their lifestyle, develop
or reconsidered following the Meetings of the State Council
appropriate targeted measures to reduce PTS intake with
Board of the Russian Federation and of the President of the
traditional food, based on specific recommendations, the
Russian Federation with the representatives of the northern
improvement of social and economic conditions and the
territories of the Russian Federation in Salekhard, 28-29
raising of awareness about existing problems.
April, 2004; should fully address improvements to the social
and economic conditions of the Russian Arctic indigenous
10.The highest PTS exposures and associated health
peoples. This action should be undertaken with the full
risks are documented for the coastal areas of
involvement of the indigenous peoples.
Chukotka, where the traditional diet of the
indigenous population is largely based on marine
8. In general, PTS levels in the natural environment
mammals and fish. This corresponds to previous
and biota of the Russian Arctic are at moderate lev-
information obtained concerning the Green-
els compared to other Arctic regions. This presents
landic and coastal Canadian indigenous popula-
a means to significantly reduce PTS intake by
tions.
indigenous peoples without intervening in their
It is recommended that, in the development of practical fol-
basic traditional lifestyle and cultural identity,
low-up measures, special attention should be paid to the sit-
through the implementation of protection and
uation in the Chukchi AO, taking into account both, the
remedial actions, including improvement of sani-
social and economic status of the indigenous peoples in this
tary conditions in the indigenous settlements and
region of Russia, and the health risks associated with PTS
by implementation of household and dietary rec-
intake. On the basis of data obtained within the framework
ommendations developed as a result of the findings
of the project, the coastal areas of the Chukchi AO are of
of this report.
main concern with respect to human health risks.
185

Overall conclusions and recommendations
11.Indoor and occupational sources of PTS, including
14.POP concentrations measured in blood serum are
contamination of dwellings, are likely to be a signif-
highly dependent on age. This phenomenon may
icant contributor to blood contamination among
reflect past exposure to POPs. The number of
indigenous peoples of the Russian Arctic. It was
breast fed children has also been found to be a sig-
found that all of the houses of indigenous people
nificant determinant of POPs serum concentra-
studied during the targeted surveys, were contami-
tions in women. Serum concentrations of lipophilic
nated by POPs, mostly by PCB and DDT. Levels of
contaminants are reduced by an increase in parity.
indoor PCB contamination correlate to levels of
Statistically significant associations have been found
PCB measured in the blood of indigenous families
between blood concentrations of total PCBs
living in these houses.
(Arochlor 1260), lead and a number of non-specific
It is recommended that remedial action to remove PTS con-
reproductive and developmental health effects such
tamination from the houses of indigenous families, should
as the prevalence of low birth weight, premature
be an important and urgent action, aimed at e improving
births, stillbirths and major structural malforma-
the social and economic status of indigenous communities.
tions. Serum concentrations of total PCBs in mater-
nal blood also appear to be associated with impacts
12.It was found that the labelling of chemicals pro-
on newborn sex ratios. In contrast with both nation-
duced and retailed for household protection
al and global statistics, female babies of indigenous
against insects and rodents, often does not corre-
mothers with elevated POP blood concentrations,
spond to their actual chemical composition, and
have a higher risk of low birth weight and other
that these chemicals sometimes contain toxic sub-
adverse outcomes of pregnancy when compared to
stances in high concentrations, particularly DDT
male babies.
and PCB.
It is recommended that the Russian human health author-
It is recommended that proposals for amendments to the
ities implement internationally recognized levels of concern
Federal Law "On safe handling of pesticides and agro-
for PTS blood concentrations. It is further recommended
chemicals" be developed, to ensure implementation of strict
that dietary safety advice based on the benefits of tradition-
and efficient control measures over the production and
al food are made an important component of prenatal care
trade of pesticides and other chemicals for private use, par-
and of family planning strategies for the indigenous com-
ticularly those used for protection against insects and
munities at risk.
rodents, which would ensure a complete ban on the use of
PTS in these chemicals.
15.A close correlation between PTS levels in blood and
breast milk has been documented for indigenous
13.In a number of cases, home-made local food con-
women of the Chukchi AO.
tains higher levels of PTS contamination than raw
It is recommended that the international and Russian
products obtained from the natural environment. It
national health and environmental protection authorities
has been shown that additional contamination of
develop recommendations for the assessment of human PTS
food by PTS can take place when food is stored,
intake, based on levels of these contaminants in blood and
processed, and/or cooked in a contaminated
breast milk, taking into account the advantages and draw-
household environment.
backs of using these indicators for different groups within
It is recommended that the local human health authorities,
the population.
in close collaboration with regional branches of RAIPON,
work out an efficient action plan to improve sanitary con-
ditions in indigenous houses. These measures should be
integrated with communication with indigenous families
and efforts to raise awareness about the health risks associ-
ated with contamination of home-processed food.
186

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