{
  "abstract": "Mercury exposure during pregnancy remains a public health concern due to its potential impact on foetal neurodevelopment. The randomised HBM4EU-MOM study (2020–2022) evaluated the effect of harmonised dietary advice on mercury exposure among 654 pregnant women from five European coastal countries. Total mercury concentrations in hair were measured at Phase 1 (baseline) and Phase 2 (follow-up). At baseline, mercury exposure varied substantially across countries, with the highest geometric mean (GM) concentrations in Portugal (1.56 μg/g) and Spain (0.90 μg/g), and lower levels in Greece, Iceland, and Cyprus (0.44 μg/g, 0.36 μg/g, and 0.31 μg/g, respectively). The primary adjusted analysis (n = 600) showed no evidence that the dietary intervention reduced follow-up hair mercury concentrations compared with the control group (adjusted geometric mean ratio [GMR] = 1.028, 95% CI 0.955–1.107; p = 0.455). Between baseline and follow-up, the GM mercury concentration across pooled participants with paired measurements decreased from 0.59 μg/g to 0.55 μg/g (−6.79%, p = 0.002), with statistically significant temporal reductions observed in Spain and Portugal, while no statistically significant temporal changes were observed in Greece, Iceland, or Cyprus. The proportion of women exceeding the EFSA exposure benchmark (1.8 μg/g) decreased from 12.5% at baseline to 7.5% at follow-up. Country-specific temporal reductions in Spain and Portugal were observed in both intervention and control groups with similar magnitudes. These findings indicate that the observed temporal decline in mercury exposure during pregnancy cannot be attributed specifically to the harmonised dietary intervention and is likely to reflect factors operating beyond the intervention itself. Although the intervention did not produce a measurable reduction in mercury exposure compared with standard care, the country-specific temporal patterns and reductions in the proportion of women exceeding health-based exposure benchmark highlight the importance of understanding the behavioural, dietary, and contextual factors influencing mercury exposure during pregnancy.",
  "abstract_shown": true,
  "affiliations": [
    "HERACLES Research Center – KEDEK, Aristotle University of Thessaloniki, Thessaloniki, Greece; Environmental Engineering Laboratory, Department of Chemical Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece; Corresponding author at: State General Laboratory, Ministry of Health, Republic of Cyprus, P.O. Box 28648, 2081 Nicosia, Cyprus.",
    "Environmental Toxicology Unit, National Centre for Environmental Health. Instituto de Salud Carlos III (CNSA-ISCIII), Madrid, Spain",
    "Department of Epidemiology, National Institute of Health Dr. Ricardo Jorge (INSA), Lisbon, Portugal; NOVA National School of Public Health, Public Health Research Centre, Universidade NOVA de Lisboa, Lisbon, Portugal; Comprehensive Health Research Center (CHRC), Lisbon, Portugal",
    "University of Iceland, Reykjavík, Iceland",
    "Jozef Stefan Institute, Ljubljana, Department of Environmental Sciences, Slovenia",
    "HERACLES Research Center – KEDEK, Aristotle University of Thessaloniki, Thessaloniki, Greece; Environmental Engineering Laboratory, Department of Chemical Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece",
    "State General Laboratory, Ministry of Health, Nicosia, Cyprus",
    "Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Avenida Padre Cruz, 1649-016 Lisbon, Portugal; Egas Moniz School & Health Science, Campus Universitário, Quinta da Granja, 2829-511 Monte de Caparica, Almada, Portugal",
    "Institute for Prevention and Occupational Medicine, Germany; Ruhr University Bochum Medical Faculty Institute for Prevention and Occupational Medicine of the German Social Accident Insurance Institute of the Ruhr University Bochum (IPA), Germany",
    "Comprehensive Health Research Center (CHRC), Lisbon, Portugal",
    "Department of Pharmacology and Toxicology, University of Iceland, Reykjavík, Iceland",
    "VITO, Mol, Belgium",
    "Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Avenida Padre Cruz, 1649-016 Lisbon, Portugal",
    "HERACLES Research Center – KEDEK, Aristotle University of Thessaloniki, Thessaloniki, Greece; Environmental Engineering Laboratory, Department of Chemical Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece; Environmental Health Engineering, School for Advanced Study IUSS, Pavia, Italy; National Hellenic Research Foundation, Athens, Athens, Greece",
    "State General Laboratory, Ministry of Health, Nicosia, Cyprus; Corresponding author at: Environmental Engineering Laboratory, Department of Chemical Engineering Aristotle University of Thessaloniki, and HERACLES Research Center – KEDEK, BALKAN CENTER, Building B, B.1.0.1, 10th km Thessaloniki - Thermi Rd, GR 57001, Greece."
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 32,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Catherine Gabriel"
    },
    {
      "affs": [
        1
      ],
      "name": "Marta Esteban-López"
    },
    {
      "affs": [
        2
      ],
      "name": "Sónia Namorado"
    },
    {
      "affs": [
        3
      ],
      "name": "Thorhallur I. Halldorsson"
    },
    {
      "affs": [
        4
      ],
      "name": "Janja Snoj Tratnik"
    },
    {
      "affs": [
        5
      ],
      "name": "Achilleas Karakoltzidis"
    },
    {
      "affs": [
        5
      ],
      "name": "Dayna R. Schultz"
    },
    {
      "affs": [
        6
      ],
      "name": "Elena Anastasi"
    },
    {
      "affs": [
        7
      ],
      "name": "Ricardo Assunção"
    },
    {
      "affs": [
        1
      ],
      "name": "Susana Pedraza-Diaz"
    },
    {
      "affs": [
        1
      ],
      "name": "Argelia Castaño"
    },
    {
      "affs": [
        5
      ],
      "name": "Anthoula Chatzimpaloglou"
    },
    {
      "affs": [
        1
      ],
      "name": "Noelia Domínguez-Morueco"
    },
    {
      "affs": [
        6
      ],
      "name": "Despina Giannadaki"
    },
    {
      "affs": [
        1
      ],
      "name": "Sara González"
    },
    {
      "affs": [
        4
      ],
      "name": "Milena Horvat"
    },
    {
      "affs": [
        3
      ],
      "name": "Eva Jacobsen"
    },
    {
      "affs": [
        5
      ],
      "name": "Spyros Karakitsios"
    },
    {
      "affs": [
        8
      ],
      "name": "Marike Kolossa-Gehring"
    },
    {
      "affs": [
        1
      ],
      "name": "Miguel Ángel Lucena"
    },
    {
      "affs": [
        9
      ],
      "name": "Carla Nunes"
    },
    {
      "affs": [
        10
      ],
      "name": "Kristin Olafsdottir"
    },
    {
      "affs": [
        5
      ],
      "name": "Nafsika Papaioannou"
    },
    {
      "affs": [
        9
      ],
      "name": "Maria Peres"
    },
    {
      "affs": [
        1
      ],
      "name": "Ana I. Cañas-Portilla"
    },
    {
      "affs": [
        11
      ],
      "name": "Laura Rodriguez Martin"
    },
    {
      "affs": [
        1
      ],
      "name": "Maria Rodríguez"
    },
    {
      "affs": [
        1
      ],
      "name": "Ana Rodríguez"
    },
    {
      "affs": [
        12
      ],
      "name": "Susana Santiago"
    },
    {
      "affs": [
        6
      ],
      "name": "Anthi Thoma"
    },
    {
      "affs": [
        13
      ],
      "name": "Dimosthenis Sarigiannis"
    },
    {
      "affs": [
        14
      ],
      "name": "Andromachi Katsonouri"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/16ywn0k1fgc8k.bib",
  "cited_by": 0,
  "doi": "10.1016/j.envint.2026.110573",
  "fulltext_url": "http://www.sciencedirect.com/science/article/pii/S0160412026005313",
  "id": "16ywn0k1fgc8k",
  "issns": [
    "0160-4120"
  ],
  "landing_url": "https://doi.org/10.1016/j.envint.2026.110573",
  "language": "en",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "journal",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "lcc",
      "GE1-350"
    ],
    [
      "openalex",
      "2307|Mercury impact and mitigation studies"
    ]
  ],
  "openalex": "W7223059332",
  "pdf_url": "https://www.sciencedirect.com/science/article/pii/S0160412026005313/pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-31",
  "publisher": "Elsevier",
  "ris": "https://research.draconitic.com/paper/16ywn0k1fgc8k.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T14:21:48Z",
      "native_id": "04bf0b6bb7974f9f9b431087b2d98414",
      "source": "doaj",
      "url": "https://doi.org/10.1016/j.envint.2026.110573"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2307|Mercury impact and mitigation studies",
      "subfield": "pharmacology-toxicology"
    }
  ],
  "title": "Mercury exposure during pregnancy and the effect of harmonised fish-consumption advice: results from the multi-country randomised HBM4EU-MOM study",
  "title_text": "Mercury exposure during pregnancy and the effect of harmonised fish-consumption advice: results from the multi-country randomised HBM4EU-MOM study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T14:21:48Z",
  "url": "https://research.draconitic.com/paper/16ywn0k1fgc8k",
  "venue": "Environment International",
  "versions": []
}