Gjógv - most northern village on Eysturoy
Gjógv - most northern village on Eysturoy
© Photo by Annie Spratt on Unsplash

The Arctic Dilemma

A conversation with Pál Weihe, chief physician and professor in public health in the Faroes Islands about the health and cultural impacts of contaminants on Arctic communities

In 2008, Professor and chief physician Pál Weihe, together with then Chief Medical officer of the Faroe Islands, publicly recommended removing pilot whale from the Faroese diet. Once a crucial food source that saved the population from starvation and remained a staple for many families, the pilot whale was found to have unsafe levels of contamination. Initially focusing on high mercury levels in the pilot whale’s meat, Weihe and his colleagues over the years discovered that the blubber also accumulated persistent organic pollutants (POPs) and per- and polyfluoroalkyl substances (PFAS). These contaminants, released across the globe, now posed a risk to the Faroese population and impacted the health of Faroese children. Yet, while the Faroese lost a traditional food source, other Arctic communities, which rely almost exclusively on marine mammals, face an even deeper Arctic dilemma.

Prof. Pál Weihe
© Credit: Harald Bjørgvin

In 1984, Prof. Pál Weihe, a Faroese occupational physician, was about to embark on a long-term study that would span the next decades of his career. A warning from the Faroese veterinary authorities some years earlier had prompted Weihe and his colleague Philippe Grandjean to investigate elevated mercury levels in pilot whales, a traditional Faroese staple food. The authorities had cautioned the public about high concentrations of the heavy metal in the whales' inner organs.

Additionally, reports of severe mercury poisoning in Minamata, Japan, which had caused detrimental effects on 10,000 residents, had raised concerns among the Faroese people. Yet, in the early eighties, no one could quantify safe and unsafe levels of mercury exposure. Long-term studies were needed.

“We started in 1984 by taking blood samples from women in fertile age in a small Faroese village, where we knew traditional diets included fish and pilot whale meat and blubber. When we found significant variations in mercury levels among these women, we realized that the Faroe Islands could serve as an ideal location for a long-term study on the effects of mercury exposure,” Weihe recalls.

“The children who had a higher prenatal exposure were not doing so well, in comparison with children that had not been exposed”, shares Weihe. “We stared right away to give recommendations to women who were planning to get pregnant.” - Pál Weihe

© Photo by Jake Hinds on Unsplash

To better understand the effects of mercury poisoning, the World Health Organization recommended studies measuring mercury exposure during pregnancy and at the time of delivery, followed by long-term follow-up as the children grew older. By 1986, Weihe and Grandjean had secured funding to conduct such a study. They established their first cohort with 1,022 participating mothers, achieving a remarkable 90% participation rate. When the children turned seven, they underwent a thorough, hour-long examination that tested their psychological abilities, intelligence, neurophysiology, and more.

“Following these examinations, we developed the statistics and found an association between high mercury exposure of the mother before birth and some decline in the children’s cognitive abilities. The children who had higher prenatal exposure were not doing as well compared to those who had not been exposed,” Weihe shares. “We immediately began recommending that women planning to get pregnant should postpone their consumption of pilot whale until after the pregnancy.”

How an ear infection exposed the impacts of another set of contaminants

Following years of giving dietary recommendations to women of child-bearing age, Weihe and Grandjean turned their attention to another group of contaminants: persistent organic pollutants (POPs). Unlike mercury, which is bound to the protein in whale meat, POPs are concentrated in the whale's fat tissue, or blubber. Among several POPs, the doctors found high concentrations of the probably carcinogenic compounds PCBs (Polychlorinated biphenyls), and the infamous insecticide DDT (Dichloro-diphenyl-trichloroethane).

While the impact of these contaminants on the brain was not as significant, Weihe and Grandjean shifted their focus to the immune system due to an unusual observation. “When we examined the first cohort in the mid-1990s, we found a high rate of middle ear infections. As similar observations had been made in other Arctic areas, we wondered if POPs could have a negative impact on the immune system. It was just an assumption,” states Weihe. Nevertheless, they decided to investigate further by analyzing the vaccine response in the population.

“What we then saw was really unexpected: we discovered a clear association between the exposure to POPs and a negative impact on the antibody formation.”- Pál Weihe

Kalsoy, Faroe Islands
© Photo by Andrew St Lawrence on Unsplash

“Basically, every child in our part of the world is offered a vaccination program, and we saw this as an opportunity,” Weihe explains. “We had a well-defined stimulus, the vaccine, and could directly measure how many antibodies formed over a month or a year. What we then saw was really unexpected: we discovered a clear association between exposure to POPs and a negative impact on antibody formation. It is a very simple model, but it clearly indicated that the contaminants had a negative impact on the immune system.”

This finding eventually brought Weihe to an ethical dilemma. During the year-seven examinations of Faroese children, in one of the six prospective birth cohorts established in the Faroes, he found that the vaccinations were not providing adequate protection. Realizing that he could not act solely as a researcher, Weihe decided, “We had to do an intervention based on our findings. So, we offered the participants a new vaccination because we could see that some of them were clearly below the protection limit.”

A third group of chemicals upends a century-long practice

Around 2005, Weihe began to study to yet another contaminant: PFAS. “Today, everyone speaks about PFAS, but we started measuring the levels of these fluorinated compounds 20 years ago and found a positive correlation between concentrations of PFAS and the whale meat consumption,” he says. Per- and polyfluoroalkyl substances (PFAS) are a large and complex group of synthetic chemicals used in consumer products worldwide since the 1950s. These chemicals are found in everyday items such as waterproof clothing, furniture, food packaging, and heat-resistant non-stick cooking surfaces. Eventually, they made their way into the bodies of various mammals, including pilot whales off the shores of the Faroe Islands.

“We saw a very dramatic influence on the antibody formation. For every doubling of PFAS at the age of 5, we could see a 50% reduction in the vaccine response at age 7.” -Pál Weihe

© Photo by Michael Fousert on Unsplash

“I remember we released a report in 2008, in which we concluded that people who eat several servings of pilot whale per week had higher PFAS values than people eating less or no whale,” Weihe shares. A marine source, therefore, seemed very likely and, much like POPs, PFAS affected people’s immune systems. “We saw a very dramatic influence on antibody formation. For every doubling of PFAS at the age of 5, we could see a 50% reduction in the vaccine response at age 7.”

Weihe realized they were facing a significant problem. For more than two decades, they had recommended that women avoid whale meat before and during pregnancy. However, POPs and PFAS are very different from mercury. While mercury has a half-life of 45 days, meaning it takes 45 days for its concentration to fall to half of its initial value, PCB can remain in the human body for many years, and PFAS are known as ‘forever chemicals’ for a reason.

How mercury, POPs and PFAS accumulate in the human body

While neither the Faroe Islands nor many other coastal Arctic communities have heavy industries using mercury, POPs, or PFAS, these pollutants still reach the region through air and ocean currents and are making their way up the food chain. As larger animals consume smaller ones that contain these contaminants, the pollutants accumulate. For each step up the food chain, contamination levels increase by a factor of 10 to 100, ultimately reaching humans at the top. Coastal Arctic communities that rely on marine mammals for their traditional lifestyle often find themselves at the seventh or eighth step of this chain, meaning contamination levels can be multiplied by a factor of up to 10,000.

“This was very problematic because if young girls are exposed to POPs or PFAS, there will not be enough time to eliminate the contaminants from their bodies if they decide to have children,” says Weihe. If a woman decided she wanted to get pregnant next year, eliminating mercury-contaminated foods like pilot whale, tuna, or halibut from her diet would be beneficial, as the mercury concentration could be reduced rapidly. However, this is not the case with persistent organic pollutants.

We had to go out and tell the Faroese people that they should not eat their traditional food anymore because it had been so heavily contaminated by human activities over the recent years. Pál Weihe

“So, the logical consequence for us was not only to give dietary recommendations to young women but to extend them to the general public. In our opinion, it wasn’t right to distribute a food item that had higher contamination levels than were generally accepted in our part of the world. We had to go out and tell the Faroese people that they should not eat their traditional food anymore because it had been so heavily contaminated by human activities over the recent years,” Weihe explains.

The message came as a shock to many. The Faroese had relied on pilot whales for centuries. When bad harvests and low fish stocks brought the population to the brink of starvation, pilot whales came to the rescue, becoming an integral part of Faroese culture. Weihe himself recalls that doctors in his childhood recommended people eat pilot whales because of the supply of proteins and vitamins in the meat and blubber. Now, at a time when increasing anti-whaling campaigns targeted Faroese whaling practices, Weihe's stance appeared absolutistic, perhaps even unpatriotic.

“So, I said to Watson if he was concerned about the well-being of pilot whales now and in the future, he should help us stop the pollution; that would be meaningful.” - Pál Weihe

Vágar, Faroe Islands
© Photo by Annie Spratt on Unsplash

“I had to convince my own people that I’m not a Trojan horse trying to impose a moratorium on whaling,” says Weihe. When confronted by Sea Shepherd founder Paul Watson about supporting the anti-whaling campaign, Weihe responded that his primary concern was the health of the Faroese public, which was his sole duty as a public health officer. “But I told him that he could help me by protecting the whales against the massive pollution caused by man-made releases of mercury, POPs, and PFAS. We have every reason to think that a high-ranking mammal like a pilot whale will suffer just as much as humans from exposure to these contaminants. So, I said to Watson, if he was concerned about the well-being of pilot whales now and in the future, he should help us stop the pollution. That would be meaningful.”

A good health story – with a gendered effect

While addressing the source of the pollution is a global responsibility, Weihe can look back at 40 years of contaminant studies and health recommendations to the Faroese public with a sense of true accomplishment. “It is actually a beautiful public health story. We have seen that women, who we initially targeted with our health recommendations, have followed them thoroughly. For example, the mercury level in the umbilical cord in 1986/87 was around 22 micrograms per liter; now it's close to 1. So, it's lower by a factor of 20, and fetuses are no longer exposed to these environmental substances. The contamination levels of many contaminants like methylmercury in the pilot whales remains the same, so the only explanation we have is that women don't eat pilot whale anymore,” says Weihe.

“We see that men are more skeptical. […] They say that we have eaten pilot whales for centuries and that it has served the Faroese people well.” - Pál Weihe

Faroe Islands, Tjørnuvík
© Photo by Annie Spratt on Unsplash

Yet, while it is a public health victory for one half of the population, Weihe and his colleagues have witnessed quite a different perspective from the opposite sex. “It is my clear impression that men are more skeptical. A lot of men, especially middle-aged and elderly, don’t think the general recommendations not to consume pilot whale at all are right. They say that we have eaten pilot whales for centuries and that it has served the Faroese people well. They ask if I can prove that the harm is caused by eating pilot whale meat and blubber – and of course, I understand, my proof is highly abstract. It’s statistical calculations published in scientific journals. So, it has proven more difficult to convince this demographic of the negative health effects the consumption of pilot whale can also have on them,” explains Weihe.

A circumpolar perspective – An Arctic dilemma

Removing a traditional food source from a nation’s menu due to contaminants that have been transported over long distances to the Arctic affects not just people’s diet but also their culture, traditions, and livelihoods. Fortunately for the Faroese, the waters off their shores are teeming with rich fish stocks, including cod, haddock, mackerel, salmon, and herring, which are low in contaminants. This made it easier for Weihe to recommend completely dropping the consumption of pilot whale meat and blubber. But not all Arctic communities are this fortunate.

“If I were to go to Qaanaaq and tell the community to stop eating marine mammals, they would solely have to rely on imported groceries. That would be a blow to their culture, and that’s what we call the Arctic dilemma.” - Pál Weihe

Ittoqqortoormiit, Greenland
© Photo by Annie Spratt on Unsplash

“In places like Qaanaaq in northwestern Greenland, people rely on seals, narwhals, and polar bears for their diets and traditional livelihoods. All of these mammals are heavily contaminated. So, if I were to go to Qaanaaq and tell the community to stop eating marine mammals, they would solely have to rely on imported groceries. That would be a blow to their culture, and that’s what we call the Arctic dilemma,” shares Weihe.

The Arctic dilemma, a term coined by the Arctic Monitoring and Assessment Programme (AMAP) in its early contaminant assessments, highlights how the long-range transport of contaminants affects the traditional way of life of Arctic Indigenous Peoples across the circumpolar Arctic.

Since the late 1990s, AMAP has been investigating the causes and effects of the Arctic dilemma. An early study in Disko Bay, Greenland, measured mercury and PCB levels in the blood of pregnant women and in the umbilical cords after birth (watch AMAP’s film about the study). The results were shocking: Nowhere else in the world had such high levels of PCBs been found, and some women had mercury levels 12 times above the limit set by the WHO.

“The price of avoiding contaminated food sources in many Arctic communities would come at the cost of their culture. It would directly threaten the existence of their societies,” emphasizes Weihe. Instead, the best advice from a public health perspective, says Pál Weihe, is to identify the least contaminated food sources. “If you, for example, have the choice between a toothed whale and a baleen whale, you should choose a baleen whale because it has lower contaminant levels due to the way they feed,” Weihe suggests.

However, in the long term, the Arctic dilemma could lead to the depopulation of Arctic communities, forcing a move to south and/or urban areas. This would mean leaving behind traditional livelihoods that have sustained people for millennia.

Main findings from AMAP’s 2021 Assessment: Human Health in the Arctic

The 2021 Human Health in the Arctic Assessment, of which Pál Weihe is one of the lead authors, provides insights to the levels of mercury, POPs, PFAS and other contaminants in Arctic populations, the health impacts of exposure to these environmental contaminants, and – for the first time – includes a detailed discussion of dietary transitions in the Arctic and their implications for the health of community members.

The assessment’s six main findings are:

  1. Traditional/country and local foods remain central to Arctic peoples’ culture and nutrient intake, yet also continue to be the main source of their exposure to contaminants.
  2. The diets of Arctic peoples are changing, with positive and negative consequences.
    Benefits include reductions in levels of contaminants in the blood of pregnant women; negative impacts include increasing obesity, metabolic disorders, and dental problems related to consuming high-sugar and processed foods.
  3. Levels of many contaminants measured in Arctic populations are declining, but levels of POPs remain higher in some Arctic populations compared with people in regions outside of the Arctic. Methylmercury and per- and polyfluoroalkyl substances (PFASs) also remain a cause for concern.
  4. Contaminants in the Arctic are associated with negative impacts on health.
  5. To better assess and compare contaminant-related health risks to Arctic populations, harmonized methods and new models for risk assessment need to be developed and used consistently across jurisdictions.
  6. Risk communication can help to reduce health impacts among Arctic populations but reducing contaminants at their source is necessary in the long term.
AMAP, 2021. Human Health in the Arctic 2021. Summary for Policy-makers

The lessons from the Faroe Islands – a message of hope?

So, what can the world learn from the Faroese case? “That we should act according to the precautionary principle,” says Weihe without hesitation. “Mercury has been with us for a very long time, but PCBs were invented in the 1920s and PFAS as recently as the 1940s. Within those decades, these pollutants have traveled around the world and reached remote areas in the Arctic.”

The precautionary principle urges us to be mindful of new chemicals and the quantities in which we release them into the environment. The Stockholm Convention on Persistent Organic Pollutants, for example, obliges countries to eliminate the use of PCBs in equipment by 2025 and to make determined efforts for the environmentally sound management of PCB-contaminated waste and equipment by 2028. However, because PCBs were used in large amounts and bioaccumulate very slowly, they will remain in the environment long after they have been completely phased out. “We might not know yet if a new chemical is degradable or harmful to the environment. Today, we act according to the principle of ‘out of sight, out of mind’ – but these chemicals will come back and claim their presence. We have documented that these substances have harmed our children in the Faroe Islands,” says Weihe.

“This is therefore the message I’m sending: Remember to act according to the precautionary principle. Chemicals with favorable technical qualities could be harmful in the long run,” Weihe urges.

When asked in closing if he is hopeful for the future, he said, “In the long-term perspective, I am, because now we have international conventions that regulate these contaminants, such as the Minamata Convention for mercury and the Stockholm Convention for POPs. This shows that we can act rationally – but it has been, and I’m certain it will continue to be, a slow process.”

AMAP Work on Human Health in the Arctic

Since the establishment of the Arctic Monitoring and Assessment Programme (AMAP) in 1991, monitoring the levels of contaminants in humans living in the Arctic and assessing their health implications has been an important focus of work. This work is coordinated by the AMAP Human Health Assessment Group (HHAG), currently co-led by Pál Weihe and Cheryl Khoury (Canada). The results of studies of contaminants and their effects in the Faroese cohorts mentioned in this article have been contributed to AMAP assessment reports together with the results of studies of contaminant levels and effects in people living in other Arctic countries. Five assessment reports on human health in the Arctic have been produced by the HHAG over the past 30 years, compiling the data on contaminant levels in selected populations and cohorts from all Arctic countries as well as their implications for health effects, risk management and communication, and more recently the ongoing transition in diets occurring in many Arctic populations. The 2021 report mentioned in the box is the fifth and most recent report in this series.

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