Use of the ecosystem approach to population health: the case of mercury contamination in aquatic environments and riparian populations, Andean Amazon, Napo River Valley, Ecuador.

BACKGROUND Driven by accelerating transformation of land use in the Amazon, studies addressing the impacts of deforestation and mercury (Hg) leaching on the geophysical, biological, social, health, economic and political systems of Amazonian countries are crucial to evaluate the population health risks of these rapid changes. METHODS We used an ecosystem approach, integrating Hg measurements with socio-cultural and politico-economic elements, to provide an integral analysis and comprehensive solutions. RESULTS Our interdisciplinary research in the Ecuadorian Andean Amazon has shown that comestible fish and riparian communities which rely on fish as a major protein source have mercury levels that could potentially cause subtle but deleterious population health alterations. A parallel study identified deforestation and soil erosion as a significant source of mercury to the aquatic ecosystem. INTERPRETATION The analysis of these results in conjunction with the prevailing socio-cultural and politico-economic context allowed us to identify economic trends, and especially petroleum exploitation, as pivotal in the deforestation/mercury-exposure dynamic. In collaboration with public health authorities, we shared our results with local health stakeholders, including public health care staff, federal government agencies, researchers and local communities, in such a way as to promote sustainable land use practices and the nutritional benefits of fish eating while reducing toxic exposures.