A public health perspective on cyanobacteria, climate change, population growth, and potential risk of neurodegenerative disease

Abstract Cyanobacteria are a global health issue. These bacteria can produce toxins (cyanotoxins) that have important health consequences and exposure can occur through multiple pathways including drinking water and seafood. While several cyanotoxins are regulated and monitored, most are not. In this perspective, we provide a narrative review describing how climate change and population growth contribute to increasing risk of cyanotoxin exposure. Next, we explore the hypothesis that cyanobacteria are associated with the development of neurodegenerative diseases. Through synthesizing this literature, we underscore the need for more exposure data to elucidate specific health effects. To demonstrate this gap and understand what data are available in British Columbia, Canada (BC), we describe the current approach to monitoring cyanobacteria and cyanotoxins in BC lakes. We identify sources of data and knowledge gaps in this BC case study that would inform exposure and exposure-health effect studies, including understanding links between cyanotoxins and neurodegenerative diseases. We find that although exposure risk is likely to be heterogenous, monitoring across BC lakes is disparate, making long-term, provincial-scale surveillance difficult. We discuss this case study with a view towards identifying opportunities in BC for performing future research and as an example for others seeking to understand the risks in their regions.