complex environmental exposures on

Overview

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Key numbers

The worker extracted the full PDF text with layout preservation twice and compared extraction hashes before commit. The following lines are copied from numeric/table-bearing regions of the PDF and retain the source units and wording where legible:

this paper is available online. Suriname: Paramaribo (N=738), Nickerie (N=204) and the mental outcomes.
To view these files, please visit tropical rainforest interior (N=201). Infants (N=992) were ►► The study has a biospecimen bank of approximately
women have been analysed. 39.1% had hair mercury (Hg) sertation research embedded in the study, thereby
from Paramaribo (N=522) were 0.64 µg/g hair (IQRs ►► The interior subcohort (N=201) was logistically dif-
0.36–1.09; range 0.00–7.12), from Nickerie (N=176) 0.73 ficult to reach, resulting in delayed recruitment of
96.1% of women ate fish, respective consumption of differential effects of exposure across gestation.
known to have high Hg levels, was 44.4%, 19.3% and
© Author(s) (or their 26.3%, respectively, and was greater among the interior
employer(s)) 2020. Re-use subcohort. 89% frequently consumed the vegetable tannia, literacy assessment in pregnant women is in progress.
commercial re-use. See rights pesticides. 24.9% of pregnant women had Edinburgh
birth, and there is mounting evidence that exposure to French Guiana and the Atlantic Ocean. Overall, 90% of
children.6–10 Exposure to contaminant mixtures can exac- rainforest interior (90% of the landmass). Suriname’s
and mercury (Hg) can potentiate each other’s toxicity, Hindustani (27%), Tribal (22%), Creole (16%), Javanese
even at individual levels below concentration expected (14%) and Indigenous (4%).17
stressors by examining the interaction between exposure account, a potential 20% lost to follow-up, we requested
function, a key neurodevelopmental outcome.13–16 Our hospital based, with the remainder (14%) taking place
research aims are to: tion (1%) occurs at home. Recruitment sites included all
status and marital status. Main maternal and infant/child to have an 80% power at a 0.05 level of significance.
naires are recorded on secure, encrypted iPads, uploaded Table 1 lists standardised validated questionnaires used
Table 1 Assessments completed by the CCREOH-MeKi Tamara Cohort with timeline
Table 1 Continued
tory, contains 13 000 samples. Table 1 lists timepoints at a BioRad CFX V.96.21 All samples are run in triplicate
collection cups, aliquoted into 10 mL plastic tubes, stored received according to acceptable standards. Quality assur-
assayed. Concentration of dsDNA is quantified with a (subcohort, N=218) from all three study sites. The six
2-isopropyl-4-methyl-6-hydroxypyrimidine, para- fish muscle tissue were measured in samples (N=5 per
sample was not available, a blood sample was obtained methyl esters, and then methylated in a 14% boron triflu-
collected (table 2). At each subsequent data collection gas chromatograph) set with a Supelcowax V.10 fused
timepoint (table 1), the child’s growth is measured and a silica capillary column (Milipore Sigma). Freshwater
Table 2 Distribution of maternal and infant characteristics
Maternal characteristics (n=1143) N % Infant characteristics (n=971) N %
study sites. Overall, 39.1% had elevated total Hg hair levels
from Nickerie (N=176) 0.73 µg/g (IQR 0.45–1.05; range
(30.2%) had high stress levels and nearly half (49.1%) of
and had lower household income. Table 2 presents base- An assessment of Surinamese agricultural produce
the Surinamese population, and >50% had no or lower endosulfan and lindane in the leafy vegetable tannia,
Of the 1069 babies born, 992 were enrolled (93%) based dietary survey of 522 participants showed that 98.2%
(figure 1). To date, the total number of biospecimens reported consumption of leafy vegetables. Tannia was the
whole blood for trace elements (N=1994), whole blood had high intake rates of tannia (≥36 g/day).36 Tannia is
serum separator tubes (N=1994), plasma (N=1994), urine
(N=1980), buccal swabs (N=941) and hair (N=876). From Dietary exposure to Hg in fish
992 infants, either cord blood (N=441) or blood from Dietary questionnaire analyses (N=990) showed an
heel prick (N=323) was collected at birth, and buccal overall fish consumption of 96.1%. Consumption of the

Methods (brief)

the journal online (http://dx.doi. enrolled at birth. Follow-up will take place until children 13 000 samples, providing the opportunity for future
permitted under CC BY-NC. No samples of which showed presence of worldwide banned Neurodevelopmental assessments and telomere length
children.6–10 Exposure to contaminant mixtures can exac- rainforest interior (90% of the landmass). Suriname’s
telomere length (TL) (buccal swab) and medication use; constructs and the outcome variable. Sample size was
Maternal data were collected during pregnancy at two
children are collected at 12, 36 and 48 months (table 1).
integrating questionnaire and biospecimen data. Data data collected from maternal participants were health
tracks analysed samples and the study’s overall biospec- version V.3 that was developed for WHO. Information
Cord or heelprick blood sample ●
tory, contains 13 000 samples. Table 1 lists timepoints at a BioRad CFX V.96.21 All samples are run in triplicate
which biospecimens are collected. All biospecimens are on duplicate plates with a standard curve and known
collected at study site hospitals and shipped to the AZP controls.
Samples collected from participants in remote areas are Trace element analyses in blood
stored at 4°C for not more than 48 hours prior to delivery Four hundred frozen maternal whole blood samples were
serum, plasma and cord blood samples are aliquoted Hygiene Trace Element Research Laboratory. A chain-
into 2 mL plastic freezer tubes and stored at −80°C. Urine of-custody approach was used to ensure samples were
samples (60 mL) are collected in sterile bar-coded urine collected, maintained, processed, stored, shipped and
protocols. blanks, blank spikes (lab fortified blanks), sample matrix

Implications

This page makes the source discoverable for category-level evidence routing. Values remain source-native and should be used only with the stated matrix, species, basis, geography, and censoring context from the paper. The page does not convert total mercury to methylmercury or use total arsenic as inorganic arsenic.

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Verification notes

Identity check: DOI, raw handle, candidate cite-key, and SHA-256 were compared against existing wiki/sources/ pages before creation.
Full-PDF read: pdftotext -layout was run on the full PDF twice; extracted text hashes matched before the page was written.
Numeric verification: numeric/table-bearing lines were selected mechanically from the verified extraction and preserved without unit conversion or rounding.
Brand firewall: the worker skips PDFs when extracted numeric lines appear brand/manufacturer-sensitive; this page contains category-level or species-level evidence only.
HMTc firewall: no threshold, percentile, pass/fail, clean/dirty, or certification math is stated.

Update history

The five most recent substantive edits to this page, classified major (evidence or structure moved), correction (a published value or statement was wrong and has been fixed), or minor (narrative rewritten without changing the underlying evidence). Each description is derived from what the edit did to this page; the linked commit is the authoritative record, routine regeneration passes are excluded, and the full version history lives in git. When DOI minting comes online (see schema docs), each entry below will also link to a version-pinned DataCite DOI.

Commit	Date	Change	Description
b01ec52c	2026-08-04	major	2 sections added
d49e450f	2026-08-03	major	5 sections added; narrative text revised