Mercury exposure during pregnancy and the effect of harmonised fish-consumption advice: results from the multi-country randomised HBM4EU-MOM study
15 affiliations
- 1HERACLES 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.
- 2Environmental Toxicology Unit, National Centre for Environmental Health. Instituto de Salud Carlos III (CNSA-ISCIII), Madrid, Spain
- 3Department 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
- 4University of Iceland, Reykjavík, Iceland
- 5Jozef Stefan Institute, Ljubljana, Department of Environmental Sciences, Slovenia
- 6HERACLES Research Center – KEDEK, Aristotle University of Thessaloniki, Thessaloniki, Greece; Environmental Engineering Laboratory, Department of Chemical Engineering, Aristotle University of Thessaloniki, Thessaloniki, Greece
- 7State General Laboratory, Ministry of Health, Nicosia, Cyprus
- 8Food 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
- 9Institute 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
- 10Comprehensive Health Research Center (CHRC), Lisbon, Portugal
- 11Department of Pharmacology and Toxicology, University of Iceland, Reykjavík, Iceland
- 12VITO, Mol, Belgium
- 13Food and Nutrition Department, National Institute of Health Dr. Ricardo Jorge, Avenida Padre Cruz, 1649-016 Lisbon, Portugal
- 14HERACLES 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
- 15State 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.
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.
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BibTeX
@article{gabriel2026mercury,
title = {{Mercury exposure during pregnancy and the effect of harmonised fish-consumption advice: results from the multi-country randomised HBM4EU-MOM study}},
author = {Catherine Gabriel and Marta Esteban-López and Sónia Namorado and Thorhallur I. Halldorsson and Janja Snoj Tratnik and Achilleas Karakoltzidis and Dayna R. Schultz and Elena Anastasi and Ricardo Assunção and Susana Pedraza-Diaz and Argelia Castaño and Anthoula Chatzimpaloglou and Noelia Domínguez-Morueco and Despina Giannadaki and Sara González and Milena Horvat and Eva Jacobsen and Spyros Karakitsios and Marike Kolossa-Gehring and Miguel Ángel Lucena and Carla Nunes and Kristin Olafsdottir and Nafsika Papaioannou and Maria Peres and Ana I. Cañas-Portilla and Laura Rodriguez Martin and Maria Rodríguez and Ana Rodríguez and Susana Santiago and Anthi Thoma and Dimosthenis Sarigiannis and Andromachi Katsonouri},
journal = {Environment International},
year = {2026},
month = oct,
doi = {10.1016/j.envint.2026.110573},
url = {https://doi.org/10.1016/j.envint.2026.110573},
note = {CC BY},
}
RIS
TY - JOUR
TI - Mercury exposure during pregnancy and the effect of harmonised fish-consumption advice: results from the multi-country randomised HBM4EU-MOM study
AU - Catherine Gabriel
AU - Marta Esteban-López
AU - Sónia Namorado
AU - Thorhallur I. Halldorsson
AU - Janja Snoj Tratnik
AU - Achilleas Karakoltzidis
AU - Dayna R. Schultz
AU - Elena Anastasi
AU - Ricardo Assunção
AU - Susana Pedraza-Diaz
AU - Argelia Castaño
AU - Anthoula Chatzimpaloglou
AU - Noelia Domínguez-Morueco
AU - Despina Giannadaki
AU - Sara González
AU - Milena Horvat
AU - Eva Jacobsen
AU - Spyros Karakitsios
AU - Marike Kolossa-Gehring
AU - Miguel Ángel Lucena
AU - Carla Nunes
AU - Kristin Olafsdottir
AU - Nafsika Papaioannou
AU - Maria Peres
AU - Ana I. Cañas-Portilla
AU - Laura Rodriguez Martin
AU - Maria Rodríguez
AU - Ana Rodríguez
AU - Susana Santiago
AU - Anthi Thoma
AU - Dimosthenis Sarigiannis
AU - Andromachi Katsonouri
PY - 2026
DA - 2026/10/31
JO - Environment International
DO - 10.1016/j.envint.2026.110573
UR - https://doi.org/10.1016/j.envint.2026.110573
AB - 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.
SN - 0160-4120
ER -