Environmental Epidemiology in Latin America: Research and Policy Development to Reduce Chemical Exposures (2016-2017)

Pollutant chemicals in Latin America have largely been unregulated for decades, resulting in high environmental exposures early and throughout one’s life, particularly in areas where large-scale development projects and extractive industries exist, such as road and dam construction, logging, mining, oil exploration and extraction. Chemical exposures during early life development can increase risk of adverse health outcomes. Pollutants such as mercury and select pesticides may be absorbed more readily in malnourished individuals and increase risk for obesity and metabolic dysfunction, which are growing problems in Latin America that coexist with severe malnutrition.

The high exposure risk and differences in nutritional vulnerability suggest significant health impacts from early-life chemical exposures in the Amazon. At the request of the Peruvian Government, this Bass Connections project team is contributing to a strategic plan to reduce heavy metal exposure. The team is helping to design a rapid assessment of heavy metal exposure in select regions of Peru, consisting of formative interviews, community market surveys, assessment of potential routes of exposure and obtaining of samples from humans and potential environmental sources of exposure.

Due to oil exploration, Ecuador has a longstanding chemical exposure problem that has existed in the Andes-Amazon region since the 1970s. The contrast between Ecuador and Peru will offer unique comparisons due to culture, politics, environmental justice and genetic predisposition. 

Team members conducted informal interviews with community leaders, health workers and residents; collected a random sample of hair from residents who visited a local health post in the prior year; conducted a community market and infrastructure survey; and collected samples of food.

Summarized assessment of qualitative data collection; completed evaluation of heavy metals across the regions; a report (in Spanish) to be shared with the Ecuadorian and Peruvian Ministries of Health and Environment; recommendations for mitigation of heavy metals exposure to stakeholders

In Fall 2016, team members reviewed the toxicology of metals exposure and current strategic plans in Cusco and Pasco, Peru. Focus areas in Spring 2017 were qualitative research methods; environmental policy; IRB requirements and CITI training and certificates; and preparation for shipping human and food samples from Peru and Ecuador.

In Summer 2017 the team is visiting regional ministries of health in Peru and identifying two to four communities to visit in each region in order to conduct informal interviews, market surveys and community infrastructure assessments. The team is also visiting regional ministries of health in Ecuador and two to four communities per region. In Fall 2017 team members will run toxicology screens for the collected data, draft a summary of results from the interviews and community data collection and compile ancillary data collected from national databases.

Team member Luiza Perez received a follow-on grant to develop a study on the efficacy of different insecticide-treated bed nets in repelling anopheles and the occupational risk factors associated with leishmaniasis in the Peruvian Amazon.


Fall 2016 – Fall 2017

Team Outputs

Axel J. Berky, Caren Weinhouse, Joao Vissoci, Nelson Rivera, Ernesto J. Ortiz, Susy Navio, J. Jaime Miranda, Andres Mallipudi, Emma Fixen, Heileen Hsu-Kim, and William K. Pan. In Utero Exposure to Metals and Birth Outcomes in an Artisanal and Small-Scale Gold Mining Birth Cohort in Madre de Dios, Peru. 2023. Environmental Health Perspectives 131:9.

Axel J. Berky, Emily Robie, Susy Navio Chipa, Ernesto J. Ortiz, Emma J. Palmer, Nelson A. Rivera, Ana Maria Morales Avalos, Joel N. Meyer, Heileen Hsu-Kim, William K. Pan. 2022. Risk of lead exposure from wild game consumption from cross-sectional studies in Madre de Dios, Peru. The Lancet.

Justin T. Lana, Andrés Mallipudi, Ernesto J. Ortiz, Jairo H. Arevalo, Alejandro Llanos-Cuentas, William K. Pan. "Risk Factors for Cutaneous Leishmaniasis in a High-altitude Forest Region of Peru." 2021. Tropical Medicine and Health 49(1):40.

Beth J. Feingold, Axel Berky, Heileen Hsu-Kim, Elvis Rojas Jurado, William K. Pan. “Population Based Dietary Exposure to Mercury Through Fish Consumption in the Southern Peruvian Amazon.” 2019. Environmental Research.

Evaluation of a Dietary Intervention for Chronic Methylmercury Exposure Among Communities in Madre de Dios, Peru (poster by Joshua Grubbs), presented at Visible Thinking, April 19, 2018

Lauren H. Wyatt, Anthony L. Luz, Xiou Cao, Laura L. Maurer, Ashley M. Blawas, Alejandro Aballay, William K.Y. Pan, Joel N. Meyer. “Effects of Methyl and Inorganic Mercury on Genome Homeostasis and Mitochondrial Function in Caenorhabditis Elegans.” 2017. DNA Repair 52:31-48.

William Pan, Impact of El Nino on Environmental Mercury and Human Exposure ($343,333 grant awarded from the National Institutes of Health, 2016)

Exploring the Eco-epidemiology of Cutaneous Leishmaniasis through an Interdisciplinary, Inter-institutional and international collaboration (poster by Bruno Valan, Jennifer Callejas, Pamela Sanchez, Maggie Skiles, Justin Lana)

Evaluation of a Dietary Intervention for Chronic Methylmercury Exposure Among Communities in Madre de Dios, Peru (poster by Delaney Dryfoos, Joshua Grubbs, Anson MacKinney, Karina Martinez Romo, William Pan, Joel Meyer, Ernesto Ortiz)

Evaluación de una Intervención Dietética para Exposición Crónica al Metilmercurio entre Comunidades en Madre de Dios, Perú (Jennifer Callejas, Delaney Dryfoos, Liane Emerson, Joshua Grubbs, Anson MacKinney, Karina Martinez Romo, Luiza Perez, William Pan, Joel Meyer, Ernesto Ortiz)

An Environmental Approach to Global Health (presentation by Justin Lana and Luiza Perez, Bass Connections Showcase, April 24, 2017)

Bass Connections Follow-on Student Research Award (Luiza Perez)


Anson MacKinney

Joshua Grubbs as a student and an alumnus

This Team in the News

Six Ph.D. Graduates Who Leveraged Bass Connections for Their Doctoral Training

Where Are They Now?

Duke Seniors Share What Was Most Meaningful about Their Bass Connections Experiences

Mercury and Masato: Deliberations from the Peruvian Amazon

Donor Generosity Helps Bring Student Field Projects to Life

Interdisciplinary Collaboration Drives Change for Mercury Toxicity in the Peruvian Amazon

Meet the Members of the 2017-18 Student Advisory Council

Bass Connections Students Win Poster and Photo Awards for Research in Uganda, Honduras, Nepal and Peru

Turning Learning into Livesaving in Peru

Three Bass Connections Faculty Leaders Receive Honors

Student Laurels and Honors for 2017

Students Present Their Research and Learn from Each Other at the Bass Connections Showcase

Student Research Shared, Awards Announced at Bass Connections Showcase

Twelve Students Receive Grants to Take Their Bass Connections Research Further

Can a Dietary Intervention Reduce Mercury Toxicity Among Native Communities in Peru?

Hidden Casualties of War: Cutaneous Leishmaniasis and the Syrian Civil War

Reflections on Mentoring from Bass Connections Graduate Students

Fostering a Collaborative Research Environment in Peru

See related teams, Environmental Epidemiology in Latin America: Impact of an Oil Spill in the Peruvian Amazon (2017-2018) and Environmental Epidemiology in Latin America: Leishmania (2015-2016).

Truck in Peru.

Team Leaders

  • Heileen Hsu-Kim, Pratt School of Engineering-Civil & Environmental Engineering
  • Joel Meyer, Nicholas School of the Environment-Environmental Sciences and Policy
  • William Pan, Nicholas School of the Environment-Environmental Sciences and Policy
  • Alexander Pfaff, Sanford School of Public Policy
  • Elizabeth Turner, School of Medicine-Biostatistics and Bioinformatics

/graduate Team Members

  • Justin Lana, Environment-PHD
  • Elizabeth Monahan, Global Health - MSc
  • Rachel Whitson, Master of Environmental Management, Ecotoxicology & Environmental Health

/undergraduate Team Members

  • Jennifer Callejas, Environmental Sci/Policy (AB), Global Health (AB2)
  • Delaney Dryfoos, Biology (BS)
  • Liane Emerson, Biology (BS), Global Health (AB2)
  • Joshua Grubbs, Chemistry (AB), Global Health (AB2)
  • Anson MacKinney, Biology (BS)
  • Karina Martinez Romo, Psychology (AB), Global Health (AB2)
  • Luiza Perez, Sociology (AB)

/yfaculty/staff Team Members

  • Ernesto Ortiz, Duke Global Health Institute