title: Evaluation of the cardiovascular effects of methylmercury exposures: current evidence supports development of a dose-response function for regulatory benefits analysis.
abstract: BACKGROUND
  The U.S. Environmental Protection Agency (U.S. EPA) has estimated the neurological benefits of reductions in prenatal methylmercury (MeHg) exposure in past assessments of rules controlling mercury (Hg) emissions. A growing body of evidence suggests that MeHg exposure can also lead to increased risks of adverse cardiovascular impacts in exposed populations.
  
  
  METHODS
  The U.S. EPA assembled the authors of this article to participate in a workshop, where we reviewed the current science concerning cardiovascular health effects of MeHg exposure via fish and seafood consumption and provided recommendations concerning whether cardiovascular health effects should be included in future Hg regulatory impact analyses.
  
  
  RESULTS
  We found the body of evidence exploring the link between MeHg and acute myocardial infarction (MI) to be sufficiently strong to support its inclusion in future benefits analyses, based both on direct epidemiological evidence of an MeHg-MI link and on MeHg's association with intermediary impacts that contribute to MI risk. Although additional research in this area would be beneficial to further clarify key characteristics of this relationship and the biological mechanisms that underlie it, we consider the current epidemiological literature sufficiently robust to support the development of a dose- response function.
  
  
  CONCLUSIONS
  We recommend the development of a dose- response function relating MeHg exposures with MIs for use in regulatory benefits analyses of future rules targeting Hg air emissions.
authors.affiliation: Industrial Economics Inc., Cambridge, Massachusetts 02140, USA. hroman@indecon.com
authors.forename: Henry A
authors.initials: HA
authors.lastname: Roman
authors.forename: Tyra L
authors.initials: TL
authors.lastname: Walsh
authors.forename: Brent A
authors.initials: BA
authors.lastname: Coull
authors.forename: Éric
authors.initials: É
authors.lastname: Dewailly
authors.forename: Eliseo
authors.initials: E
authors.lastname: Guallar
authors.forename: Dale
authors.initials: D
authors.lastname: Hattis
authors.forename: Koenraad
authors.initials: K
authors.lastname: Mariën
authors.forename: Joel
authors.initials: J
authors.lastname: Schwartz
authors.forename: Alan H
authors.initials: AH
authors.lastname: Stern
authors.forename: Jyrki K
authors.initials: JK
authors.lastname: Virtanen
authors.forename: Glenn
authors.initials: G
authors.lastname: Rice
mesh_terms: D002319:Cardiovascular System / Q000187:drug effects*; D006801:Humans; D008767:Methylmercury Compounds / Q000633:toxicity*; D009203:Myocardial Infarction / Q000139:chemically induced / Q000453:epidemiology; D014481:United States; D014484:United States Environmental Protection Agency
chemical_list: D008767:Methylmercury Compounds