Publikationer

Zoonotic infections transmitted from marine mammals to humans in the Baltic and European Arctic are of unknown significance, despite given considerable potential for transmission due to local hunt. Here we present results of an initial screening for Brucella spp. in Arctic and Baltic seal species. Baltic ringed seals (Pusa hispida, n = 12) sampled in October 2015 and Greenland Sea harp seals (Pagophilus groenlandicus, n = 6) and hooded seals (Cystophora cristata, n = 3) sampled in March 2015 were serologically analysed for antibodies against Brucella spp. The serological analyses were performed using the Rose Bengal Test (RBT) followed by a confirmatory testing of RBT-positive samples by a competitive-enzyme linked immunosorbent assay (C-ELISA). Two of the Baltic ringed seals (a juvenile male and a juvenile female) were seropositive thus indicating previous exposure to a Brucella spp. The findings indicate that ringed seals in the Baltic ecosystem may be exposed to and possibly infected by Brucella spp. No seropositive individuals were detected among the Greenland harp and hooded seals. Although our initial screening shows a zoonotic hazard to Baltic locals, a more in-depth epidemiological investigation is needed in order to determine the human risk associated with this.

For the last two and a half decades, a network of human health experts under the Arctic Monitoring and Assessment Program (AMAP) has produced several human health assessment reports. These reports have provided a base of scientific knowledge regarding environmental contaminants and their impact on human health in the Arctic. These reports provide scientific information and policy-relevant recommendations to Arctic governments. They also support international agreements such as the Stockholm Convention on Persistent Organic Pollutants (POPs) and the Minamata Convention on Mercury. Key topics discussed in this paper regarding future human health research in the circumpolar Arctic are continued contaminant biomonitoring, health effects research and risk communication. The objective of this paper is to describe knowledge gaps and future priorities for these fields.

Diabetes mellitus is a large and growing worldwide health issue. Prior to this publication, a direct comparison of the prevalence of persons treated with anti-diabetic medicine in Greenland and Denmark has not been found. Therefore, the aim of this study is to estimate and compare the age- and gender-specific prevalence of patients treated with anti-diabetic medicine comparing Greenland and Denmark. The study was performed as a cross-sectional register study using data from population and medical registers in Greenland and Denmark. A total of 784 Greenlandic and 215,580 Danish patients treated with anti-diabetic medicine were included. The prevalence of patients aged 20–79 years treated with anti-diabetic medicine in Greenland was 2.6% (95% CI 2.4–2.8), much lower (p < 0.001) compared to Denmark with 5.2% (95% CI 5.2–5.2). The difference was less pronounced after excluding those treated with insulin and women below 45 years treated with metformin. In conclusion, this study showed a lower prevalence of patients treated with anti-diabetic medicine in Greenland than Denmark. The main reason may be a much higher prevalence of undiagnosed diabetes in Greenland, particularly among the middle-aged. Differences in awareness of diabetes and access to continued primary healthcare may be contributing factors.

Background: During past decades the formerly active lifestyle in Greenland has become sedentary, and the intake of traditional food has gradually been replaced with imported food. These lifestyle and dietary habits may affect pregnant women. Aim: To describe age and regional differences in reproductive factors, lifestyle and diet among Greenlandic pregnant women in their first trimester. Methods: A cross-sectional study during 2013–2015 including 373 pregnant women was conducted in five Greenlandic regions (West, Disko Bay, South, North and East). Interview-based questionnaires on reproductive factors, lifestyle and dietary habits were compared in relation to two age groups (median age ≤28 years and >28 years). Results: In total, 72.4% were Inuit, 46.6% had BMI >25.0 kg/m2, 29.0% were smoking during pregnancy and 54.6% had used hashish. BMI, educational level, personal income, previous pregnancies and planned breastfeeding period were significantly higher in the age group >28 years of age compared to the age group ≤28 years of age. In region Disko Bay, 90.9% were Inuit, in region South more had a university degree (37.9%) and region East had the highest number of previous pregnancies, the highest number of smokers during pregnancy and the most frequent intake of sauce with hot meals and fast-food. Conclusions: Overall a high BMI and a high smoking frequency were found. Age differences were found for BMI and planned breastfeeding period, while regional differences were found for smoking and intake of sauce with hot meals and fast-food. Future recommendations aimed at pregnant women in Greenland should focus on these health issues.

Zoonotic infections transmitted from terrestrial and marine mammals to humans in European Arctic are of unknown significance, despite considerable potential for transmission due to local hunt and a rapidly changing environment. As an example, infection with Brucella bacteria may have significant impact on human health due to consumption of raw meat or otherwise contact with tissues and fluids of infected game species such as muskoxen and polar bears. Here, we present serological results for Baffin Bay polar bears (Ursus maritimus) (n = 96) and North East Greenland muskoxen (Ovibos moschatus) (n = 32) for antibodies against Brucella spp. The analysis was a two-step trial initially using the Rose Bengal Test (RBT), followed by confirmative competitive enzyme-linked immunosorbent assays of RBT-positive samples. No muskoxen had antibodies against Brucella spp., while antibodies were detected in six polar bears (6.25%) rendering a seroprevalence in line with previous findings in other Arctic regions. Seropositivity was not related to sex, age or biometrics i.e. size and body condition. Whether Brucella spp. antibodies found in polar bears were due to either prey spill over or true recurrent Brucella spp. infections is unknown. Our results therefore highlight the importance of further research into the zoonotic aspects of Brucella spp. infections, and the impact on wildlife and human health in the Arctic region.

This study investigated the effects of single nucleotide polymorphisms (SNPs) in xenobiotic and steroid hormone‐metabolizing genes in relation to breast cancer risk and explored possible effect modifications on persistent organic pollutants (POPs) and breast cancer associations. The study also assessed effects of Greenlandic BRCA1 founder mutations. Greenlandic Inuit women (77 cases and 84 controls) were included. We determined two founder mutations in BRCA1: Cys39Gly (rs80357164) and 4684delCC, and five SNPs in xenobiotic and oestrogen‐metabolizing genes: CYP17A1 ‐34T>C (rs743572), CYP19A1 *19C>T (rs10046), CYP1A1 Ile462Val (rs1048943), CYP1B Leu432Val (rs1056836) and COMT Val158Met (rs4680). We used chi‐square test for comparison of categorical variables between groups. Odds ratio (OR) estimates with 95% confidence interval (95%CI) were obtained using logistic regression models. The variant allele of BRCA1 Cys39Gly increased breast cancer risk (Gly/Cys versus Cys/Cys, OR: 12.2, 95%CI: 1.53; 98.1), and carriers of the variant allele of CYP17A1 ‐34T>C had reduced risk (CT+CC versus TT, OR: 0.44, 95%CI: 0.21; 0.93). CYP17A1 ‐34T>C was an effect modifier on the association between perfluoroalkyl acids (PFAAs) and breast cancer risk (∑PFAA, ratio of OR: 0.18, 95%CI: 0.03; 0.97). Non‐significant modifying tendencies were seen for the other SNPs on the effect of polychlorinated biphenyls, organochlorine pesticides and PFAAs. In summary, the BRCA1 Cys39Gly and CYP17A1 ‐34T>C genetic variations were associated with breast cancer risk. Our results indicate that the evaluated genetic variants modify the effects of POP exposure on breast cancer risk; however, further studies are needed to document the data from the relatively small sample size.

The Arctic populations have high blood concentrations of persistent organic pollutants (POPs). Exposure to POPs was related to adverse health effects e.g. immune, neurological and reproductive systems. This study investigates associations between serum POP levels and haematological markers in Greenlandic pregnant women. This cross-sectional study included 189 women enrolled in 2010–2011 at the Greenlandic West coast by the inclusion criteria ≥18 years of age and had lived for 50% or more of their life in Greenland. The associations between the sum of the POP variables polychlorinated biphenyls (sumPCBs), organochlorine pesticides (sumOCPs), perfluoroalkylated substances (sumPFASs) and 24 haematological markers were analysed using linear regression adjusted for age, pre-pregnancy BMI, parity, gestation week, plasma-cotinine and alcohol intake. It showed a significantly inverse association between several haematological markers (eosinophil, lymphocyte, neutrophil and white blood cells) and sumPCBs, sumOCPs and sumPFASs. In addition, the monocyte, mean corpuscular haemoglobin concentration, plateletcrit and platelet count markers were significantly inversely associated with sumPFASs, but the haematocrit and mean erythrocyte corpuscular volume were positively associated with sumPFASs. In conclusion, exposure to POPs influenced several haematological markers, especially cell count parameters, suggesting immunosuppressive potential of POPs in Greenlandic pregnant women. The data need further investigations.

Background: During past decades the formerly active lifestyle in Greenland has become sedentary, and the intake of traditional food has gradually been replaced with imported food. These lifestyle and dietary habits may affect pregnant women. Aim: To describe age and regional differences in reproductive factors, lifestyle and diet among Greenlandic pregnant women in their first trimester. Methods: A cross-sectional study during 2013–2015 including 373 pregnant women was conducted in five Greenlandic regions (West, Disko Bay, South, North and East). Interview-based questionnaires on reproductive factors, lifestyle and dietary habits were compared in relation to two age groups (median age ≤28 years and >28 years). Results: In total, 72.4% were Inuit, 46.6% had BMI >25.0 kg/m2, 29.0% were smoking during pregnancy and 54.6% had used hashish. BMI, educational level, personal income, previous pregnancies and planned breastfeeding period were significantly higher in the age group >28 years of age compared to the age group ≤28 years of age. In region Disko Bay, 90.9% were Inuit, in region South more had a university degree (37.9%) and region East had the highest number of previous pregnancies, the highest number of smokers during pregnancy and the most frequent intake of sauce with hot meals and fast-food. Conclusions: Overall a high BMI and a high smoking frequency were found. Age differences were found for BMI and planned breastfeeding period, while regional differences were found for smoking and intake of sauce with hot meals and fast-food. Future recommendations aimed at pregnant women in Greenland should focus on these health issues.