The toxicity of methylmercury (MeHg) in humans is well established and the main source of exposure is via the consumption of large marine fish and mammals. Of particular concern are the potential neurodevelopmental effects of early life exposure to low-levels of MeHg. Therefore, it is important that pregnant women, children and women of childbearing age are, as far as possible, protected from MeHg exposure. Within the European project DEMOCOPHES, we have analyzed mercury (Hg) in hair in 1799 mother-child pairs from 17 European countries using a strictly harmonized protocol for mercury analysis. Parallel, harmonized questionnaires on dietary habits provided information on consumption patterns of fish and marine products. After hierarchical cluster analysis of consumption habits of the mother-child pairs, the DEMOCOPHES cohort can be classified into two branches of approximately similar size: one with high fish consumption (H) and another with low consumption (L). All countries have representatives in both branches, but Belgium, Denmark, Spain, Portugal and Sweden have twice as many or more mother-child pairs in H than in L. For Switzerland, Czech Republic, Hungary, Poland, Romania, Slovenia and Slovakia the situation is the opposite, with more representatives in L than H. There is a strong correlation (r=0.72) in hair mercury concentration between the mother and child in the same family, which indicates that they have a similar exposure situation. The clustering of mother-child pairs on basis of their fish consumption revealed some interesting patterns. One is that for the same sea fish consumption, other food items of marine origin, like seafood products or shellfish, contribute significantly to the mercury levels in hair. We conclude that additional studies are needed to assess and quantify exposure to mercury from seafood products, in particular. The cluster analysis also showed that 95% of mothers who consume once per week fish only, and no other marine products, have mercury levels 0.55 μg/g. Thus, the 95th percentile of the distribution in this group is only around half the US-EPA recommended threshold of 1 μg/g mercury in hair. Consumption of freshwater fish played a minor role in contributing to mercury exposure in the studied cohort. The DEMOCOPHES data shows that there are significant differences in MeHg exposure across the EU and that exposure is highly correlated with consumption of fish and marine products. Fish and marine products are key components of a healthy human diet and are important both traditionally and culturally in many parts of Europe. Therefore, the communication of the potential risks of mercury exposure needs to be carefully balanced to take into account traditional and cultural values as well as the potential health benefits from fish consumption. European harmonized human biomonitoring programs provide an additional dimension to national HMB programs and can assist national authorities to tailor mitigation and adaptation strategies (dietary advice, risk communication, etc.) to their country's specific requirements.

BiPRO Munich Germany

CHU of Liege Laboratory of Clinical Forensic and Environmental Toxicology Liege Belgium

Departament of Public Health University of Copenhagen Copenhagen Demark

Department of Community of Health Health Service Executive Kildare Ireland

Department of Environmental Sciences Jožef Stefan Institute Ljubljana Slovenia

Department of Hygiene Social and Environmental Medicine Ruhr University Bochum Germany

DG Environment Federal Public Service Health Food Chain Safety and Environment Brussels Belgium

Environmental Health Center Cluj Napoca Romania

Environmental Risk and Health Flemish Institute for Technological Research Mol Belgium

Environmental Toxicology Centro Nacional de Sanidad Ambiental 28220 Majadahonda Madrid Spain

European Commission Joint Research Centre Institute of Environment and Sustainability 21027 Ispra Italy

Federal Environment Agency Dessau Rosslau Berlin Germany

Federal Office of Public Health Berne Switzerland

Institute for Prevention and Occupational Medicine of the German Social Accident Insurance Institute of the Ruhr Universität Bochum Germany

Institute of Environmental Medicine Karolinska Institutet Stockholm Sweden

Instituto de Investigacion de Enfermedades Raras Madrid Spain

Laboratoire National de Santé Dudelange Luxembourg

Larnaca General Hospital Larnaca Cyprus

Lisbon Faculty of Medicine Lisbon Portugal

Luxembourg Institute of Science and Technology Louxembourg

National Institute of Environmental Health Budapest Hungary

National Institute of Public Health Prague Czech Republic

Nofer Institute of Occupational Medicine Lodz Poland

Public Analyst's Laboratory Health Service Executive Cork Ireland

Public Health Authority of the Slovak Republic Bratislava Slovak Republic

Public Health England Centre for Radiation Chemical and Environmental Hazards Chilton United Kingdom

State General Laboratory Nicosya Cyprus

University of Leuven Leuven Belgium

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