Asia Pacific Journal of Medical Toxicology

“Low-Dose, Long-Term” Toxic Exposures Among “Indigenous Peoples in Canada”: Impacts of Inequality, Environmental Health Challenges, and the Need for a Comprehensive Approach

Document Type : Review Article

Authors

Federico Andrade-Rivas
Reza Afshari
Annalee Yassi

School of Population and Public Health, Faculty of Medicine, University of British Columbia, Canada

https://doi.org/10.22038/apjmt.2025.86687.1504
Abstract
Indigenous Peoples in Canada face disproportionate environmental health burdens from long-term, low-dose toxic exposures, driving marked health disparities. These exposures stem from the unequal siting and legacy of industrial contamination—including historical mercury dumping—compounded by socioeconomic inequities and ecosystem degradation. Drawing on our program of research, including a community-based mixed-methods case study that integrated community narratives with biomonitoring data, we synthesize evidence and propose countermeasure strategies that public-health toxicologists can apply in Indigenous contexts and, by analogy, to minority populations in low- and middle-income countries. Despite meaningful progress to reduce exposures and revitalize traditional practices, many communities still face risk—from contaminated food sources and from limited access to care that reflects their cultures and needs. These challenges are compounded by structural racism within health systems. We recommend a practical, culturally grounded approach to environmental health: listen first to Indigenous knowledge, design programs with communities (not for them), and place decision-making with Indigenous leadership. Done well, this confronts cumulative harms, strengthens community resilience, and—most importantly—reduces health inequities.
 We outline population-level, sustainable actions for health authorities, including community-driven monitoring, food-system remediation, risk communication co-designed with Elders, and policy frameworks that honour Indigenous sovereignty and the principles of relevance, respect, and reciprocity. Implementing such collaborative strategies is essential to reduce toxic exposures among Indigenous Peoples in Canada and offers transferable guidance for protecting minority communities globally.

Keywords

Social determinants of health
Health equity
Toxic exposure
Indigenous population
Persistent organic pollutants (POP)
Subjects
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Asia Pacific Journal of Medical Toxicology
Volume 14, Issue 3
Summer 2025
Pages 118-123

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