title: Association between environmental contaminants and health outcomes in indigenous populations of the Circumpolar North.
abstract: Since the 1990s, research has been carried out to monitor environmental contaminants and their effects on human health in the Arctic. Although evidence shows that Arctic indigenous peoples are exposed to higher levels of contaminants and do worse on several dimensions of health compared with other populations, the contribution of such exposures on adverse outcomes is unclear.
  
  
  
  The purpose of this review is to provide a synopsis of the published epidemiological literature that has examined association between environmental contaminants and health outcomes in Arctic indigenous populations.
  
  
  
  A literature search was conducted in OVID Medline (1946-January 2014) using search terms that combined concepts of contaminant and indigenous populations in the Arctic. No language or date restrictions were applied. The reference lists of review articles were hand-searched.
  
  
  
  Of 559 citations, 60 studies were relevant. The studies fell under the following categories: paediatric (n=18), reproductive health (n=18), obstetrics and gynaecology (n=9), cardiology (n=7), bone health (n=2), oncology (n=2), endocrinology (n=2) and other (n=2). All studies, except one from Arctic Finland, were either from Nunavik or Greenland. Most studies assessed polychlorinated biphenyls (n=43) and organochlorine pesticides (n=29). Fewer studies examined heavy metals, perfluorinated compounds, or polybrominated diphenyl ethers. Details of study results for each health category are provided.
  
  
  
  It is difficult to make conclusive statements about the effects of environmental contaminants on health due to mixed results, small number of studies and studies being restricted to a small number of regions. Meta-analytical synthesis of the evidence should be considered for priority contaminants and health outcomes. The following research gaps should be addressed in future studies: association of contaminants and health in other Arctic regions (i.e. Inuvialuit Settlement Region, Nunavut, Nunatsiavut, Alaska, European North and Russian North); assessment of contaminants on chronic diseases; inclusion of clinical endpoints in assessments; and assessment of the emerging contaminants of perfluorinated compounds and polybrominated diphenyl ethers.
authors.affiliation: Department of Biology, University of Ottawa, Ottawa, ON, Canada.
authors.forename: Kavita
authors.initials: K
authors.lastname: Singh
authors.affiliation: Department of Health, Centre for Health Research in Greenland, Greenland Government and University of Greenland, Nuuk, Greenland.
authors.forename: Peter
authors.initials: P
authors.lastname: Bjerregaard
authors.affiliation: Canada Research Chair in Toxicology and Environmental Health, Center for Advanced Research in Environmental Genomics, University of Ottawa, Ottawa, ON, Canada; laurie.chan@uottawa.ca.
authors.forename: Hing Man
authors.initials: HM
authors.lastname: Chan
mesh_terms: D000413:Alaska; D001110:Arctic Regions; D004781:Environmental Exposure / Q000009:adverse effects*; D004784:Environmental Monitoring / Q000379:methods*; D004785:Environmental Pollutants / Q000009:adverse effects* / Q000737:chemistry*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D010575:Pesticides / Q000009:adverse effects; D011078:Polychlorinated Biphenyls / Q000009:adverse effects; D044382:Population Groups / Q000706:statistics & numerical data*
chemical_list: D004785:Environmental Pollutants; D010575:Pesticides; D011078:Polychlorinated Biphenyls
keywords: environment; epidemiology; human health; pesticides; polychlorinated biphenyls; review