Further complications to predicting toxicological responses arise from the traditional and subsistence lifestyles of many Native communities that create distinct exposure patterns not captured in the assumptions of standard suburban, recreational, or occupational exposure scenarios used for risk assessments.
In addition, many of the Native communities in proximity to these waste sites have numerous risk factors associated with disparities in health outcomes such as poverty, educational status, infrastructure, and frequently, compromised underlying health status. Understanding the health impacts of these exposures is complicated by a lack of understanding of the toxicity of metals in complex mixtures in any population, exacerbated by a general lack of environmental health studies in Native populations in particular. The political and social context in which these exposures developed highlights a history of environmental injustices based in clashes of cultural values, and political and ethical failures to support negotiated treaty rights. Biomonitoring in the Strong Heart Study cohort which included Native Americans from these Western states supports increased metal exposures by identifying unique patterns of elevated metal mixtures relative to several other races in urban, suburban, and rural settings.
Contamination of soil and water by waste from more than 160,000 abandoned hard rock mines throughout the Western USA (operationally defined to include Arizona, California, Colorado, Idaho, Montana, Nevada, New Mexico, Oregon, South Dakota, Utah, Washington, and Wyoming) has created a legacy of chronic exposures to metal mixtures in Native American communities.
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