Comparative Analysis of State Fish Consumption Advisories Targeting Sensitive Populations

Objective

Fish consumption advisories are issued to warn the public of possible toxicological threats from consuming certain fish species. Although developing fetuses and children are particularly susceptible to toxicants in fish, fish also contain valuable nutrients. Hence, formulating advice for sensitive populations poses challenges. We conducted a comparative analysis of advisory Web sites issued by states to assess health messages that sensitive populations might access.

Data sources

We evaluated state advisories accessed via the National Listing of Fish Advisories issued by the U.S. Environmental Protection Agency.

Data extraction

We created criteria to evaluate advisory attributes such as risk and benefit message clarity.

Data synthesis

All 48 state advisories issued at the time of this analysis targeted children, 90% (43) targeted pregnant women, and 58% (28) targeted women of childbearing age. Only six advisories addressed single contaminants, while the remainder based advice on 2–12 contaminants. Results revealed that advisories associated a dozen contaminants with specific adverse health effects. Beneficial health effects of any kind were specifically associated only with omega-3 fatty acids found in fish.

Conclusions

These findings highlight the complexity of assessing and communicating information about multiple contaminant exposure from fish consumption. Communication regarding potential health benefits conferred by specific fish nutrients was minimal and focused primarily on omega-3 fatty acids. This overview suggests some lessons learned and highlights a lack of both clarity and consistency in providing the breadth of information that sensitive populations such as pregnant women need to make public health decisions about fish consumption during pregnancy.     

A framework and information needs for the management of the risks from consumption of self-caught fish

Governmental agencies deal with the potential risk from consuming fish contaminated with toxic chemicals by issuing fish consumption advisories. Yet such advisories are often ignored by the general public, who continue to fish and consume self-caught fish that are the subject of advisories and are from contaminated waters. Further, people are often unaware of specific warnings (which species to avoid, who is vulnerable, when they are vulnerable). In this paper we propose a more inclusive framework for examining consumption behavior of self-caught fish and identify information needs for effective communication. We include not only the usual variables that are used for calculating risk from fish consumption (meal frequency, meal size, contaminant levels) but also other aspects of behavior that contribute to risk. These include attitudes (trust, risk aversion, environmental concerns), behavior (sources of information, cultural mores, personal preferences), exposure (physical proximity, ingestion rates, bioavailability, target tissues), contaminant levels, individual host differences, and hazards (levels of contaminants). We suggest that attitudes and behavior shape risk as much as exposure and hazards and that all four of these factors must be considered in risk management. Factors such as gender, age, pregnancy status, and nutrition all influence who is at risk, while other consumption factors affect these at-risk populations, including meals/week, meal size, cooking method, fish species and sizes eaten, and years of fish consumption. Similarly, contaminant levels in fish vary by fish species, fish size and age, part of the fish, and collection location. Elucidating the risk to individual consumers involves integrating this range of factors, and managing the risk likewise involves incorporating these factors. We suggest that development of appropriate advisories and compliance with advisories will occur only if managers, risk assessors, and public policy makers consider this whole range of factors and not just the traditional fish consumption rate (often underestimated) and contaminant levels in fish (often undersampled). Merely informing the public of contaminant levels or the risk from contaminants will not ensure a public that has enough information to make informed decision, or to be in compliance with consumption advisories, or to effect changes in consumption behavior where public health is at risk.     

Risks and benefits of consumption of Great Lakes fish

Background: Beneficial effects of fish consumption on early cognitive development and cardiovascular health have been attributed to the omega-3 fatty acids in fish and fish oils, but toxic chemicals in fish may adversely affect these health outcomes. Risk–benefit assessments of fish consumption have frequently focused on methylmercury and omega-3 fatty acids, not persistent pollutants such as polychlorinated biphenyls, and none have evaluated Great Lakes fish consumption.Objectives: The risks and benefits of fish consumption have been established primarily for marine fish. Here, we examine whether sufficient data are available to evaluate the risks and benefits of eating freshwater fish from the Great Lakes.Methods: We used a scoping review to integrate information from multiple state, provincial, and federal agency sources regarding the contaminants and omega-3 fatty acids in Great Lakes fish and fish consumers, consumption rates and fish consumption advisories, and health effects of contaminants and omega-3 fatty acids.Data synthesis: Great Lakes fish contain persistent contaminants—many of which have documented adverse health effects —that accumulate in humans consuming them. In contrast, data are sparse on omega-3 fatty acids in the fish and their consumers. Moreover, few studies have documented the social and cultural benefits of Great Lakes fish consumption, particularly for subsistence fishers and native communities. At this time, federal and state/provincial governments provide fish consumption advisories based solely on risk.Conclusions: Our knowledge of Great Lakes fish has critical gaps, particularly regarding the benefits of consumption. A risk–benefit analysis requires more information than is currently available on the concentration of omega-3 fatty acids in Great Lakes fish and their absorption by fish eaters in addition to more information on the social, cultural, and health consequences of changes in the amount of fish consumed.     

An examination of the trade-offs in public health resulting from the use of default exposure assumptions in fish consumption advisories

Efforts to provide for public health protection from environmental contaminants in fish have resulted in various advisories or recommendations with regard to fish consumption from local, state, and federal agencies. These advisories are based on measured levels of contaminants in fish that are combined with values for body weight and portion size to produce an estimate of an "acceptable" consumption frequency (e.g., eat no more than once per month). Because values for body weight and portion size are generally generic default values, they do not necessarily relate to a specific population or to any individual in that population. Thus, the use of default values may result in underprotection or overprotection in any given case. Given the benefits of fish consumption and the risks from overexposure to various toxicants, vigilance is required by custodians of public health to ensure that populations are protected while being cautious not to over- or underprotect them. In this analysis, we examine the "acceptable" consumption limits derived for fish species/groups consumed by three specific populations and determine the extent of public health protection afforded by these limits. To accomplish this, the "acceptable" consumption frequencies are derived based, in part, on default assumptions and are compared to intakes calculated from empirically derived species-specific individual consumption and demographic data. Sensitivity analyses and population-specific probabilistic assessments of exposure are conducted to identify those values and/or assumptions which might significantly influence the resulting fish consumption advisories. Three populations were chosen for study based on their ability to represent populations of greatest concern: those most sensitive and/or those most exposed. We conclude from this investigation that consumption pattern data, contaminant data and body weight data together can be used to make fish consumption advisories more focused and, therefore, less likely to be under- or overprotective.     

An ecosystem approach to the health effects of mercury in the Great Lakes basin ecosystem

New concerns about the global presence and human health significance of mercury have arisen as a result of recent epidemiological data demonstrating subtle neurological effects from consumption of mercury-contaminated fish. In the Great Lakes Basin, the complexity of the diverse sources, pools, and sinks of mercury and of the pathways of distribution, fate, and biotransformation requires an ecosystem approach to the assessment of exposures of Great Lakes' human populations. Further epidemiological research is needed to verify preliminary indications of harmful effects in people living near the Great Lakes. Great Lakes fish are valuable resources for subsistence nutrition, recreation, and commerce, but the benefits of fish consumption must be balanced by concern for the hazards from the contaminants that they may contain. The efficacy of fish consumption advisories in reducing exposures should continue to be evaluated while planning continues for remedial actions on contaminated sediments from historic industrial activities and for regulatory action to control sources.     

Fish consumption and advisory awareness among the Philadelphia Asian community: a pilot study

Difficulties in the risk communication of fish consumption arise from the concept that this consumption can have both harmful and beneficial effects. This is particularly an issue among populations for which seafood is a major dietary and cultural component. Fish advisories are an important tool in preventing overconsumption of fish that have elevated concentrations of toxic contaminants. The exploratory pilot study described in this article examined fish consumption patterns and knowledge of the potential health risks associated with overconsumption of mercury-contaminated fish within a limited (N = 34) sample of the Philadelphia Asian-American population. Study data were used to evaluate the efficacy of state-issued advisories designed to encourage safe levels of fish consumption within the study population. Results indicate that while advisory awareness levels among study participants were greater than previously observed in Asian-American populations, consumption levels remained high. The limited findings of the authors' study, in combination with existing evidence, suggest the need for the development of more effective methods of disseminating advisory information.     

Human health research and policy development: experience in the Great Lakes region

As a direct outgrowth of industrial and agricultural activities, the quality of the Great Lakes ecosystem has declined significantly because of toxic substances in the water, eutrophication, overfishing, and invasive species that have been introduced into the waterways. Although measures have been adopted to restore the health of the ecosystem, contamination of Great Lakes sport fish continues arising from conditions that still prevail, but on a more limited scale. As a consequence, the Great Lakes states have issued guidelines for the public in the form of health advisories for fish consumption to encourage practices that will minimize exposure to contaminants found in Great Lakes sport fish. Scientific research has strongly influenced many policy decisions, including the development of laws, rules, and guidelines applicable to public health not only in regard to fish advisories but also other issues impacting human health. This paper proposes to outline how policy has been influenced by scientific findings and the far-reaching effect that these decisions have had on the health status of the public in the Great Lakes area and its potential for influencing the nation as a whole and our global neighbors. Within the Great Lakes basin, polychlorinated biphenyls (PCB) and mercury are the subject of the greatest number of fish advisories. Great Lakes-based researchers have studied populations residing in the Great Lakes basin to determine their level of awareness concerning fish consumption health advisories. They found that almost 50% of the residents who consumed Great Lakes sport fish were aware of sport fish consumption advisories. Of those with awareness, almost 60% were males and only about 40% were females. The researchers attributed the greater awareness among males to the health advisory materials that males receive with their fishing licenses and to their contact with fishing-related groups. The lower level of awareness among women regarding fish consumption advisories subsequently prompted the researchers to recommend targeting risk communication programs for female consumers of Great Lakes sport fish, particularly women of reproductive age. The Wisconsin Department of Health and Family Services subsequently followed the recommendation and developed uniform outreach materials for women, minorities, and the general public to be used by the Great Lakes states. The policy change directing educational materials to at-risk groups (e.g., women of reproductive age and minorities) is a direct outgrowth of the finding of low awareness about fish advisories among women who were interviewed.     

Fish consumption and advisory awareness in the Great Lakes Basin

More than 61 million adults live in the eight U.S. states bordering the Great Lakes. Between June 2001 and June 2002, a population-based, random-digit-dial telephone survey of adults residing in Great Lakes (GL) states was conducted to assess consumption of commercial and sport-caught fish and awareness of state-issued consumption advisories for GL fish. On the basis of the weighted survey data, approximately 84% of the adults living in these states included fish in their diets. Seven percent (an estimated 4.2 million adults) consumed fish caught from the Great Lakes. The percentage of residents who had consumed sport-caught fish (from any water source) varied regionally and was highest among those who lived in Minnesota (44%) and Wisconsin (39%). Consumption of GL sport fish was highest among residents of Michigan (16%) and Ohio (12%). Among residents who had eaten GL fish, awareness of consumption advisories varied by gender and race and was lowest among women (30%) and black residents (15%). However, 70% of those who consumed GL sport-caught fish twice a month or more (an estimated 509,000 adults across all eight states) were aware of the advisories. Findings from this survey indicate that exposure to persistent contaminants found in GL fish is likely limited to a relatively small subpopulation of avid sport-fish consumers. Results also underscore the public health importance of advisories for commercial fish because an estimated 2.9 million adults living in these states consume more than 104 fish meals per year and may be at risk of exceeding the reference doses for methylmercury, polychlorinated biphenyls, and other bioaccumulative contaminants.     

A possible approach for setting a mercury risk-based action level based on tribal fish ingestion rates

Risks from mercury and other contaminants in fish for a large Columbia River dataset are evaluated in this paper for a range of consumption rates. Extensive ethnohistorical, nutritional, recent ethnographic surveys, and other documentation was reviewed to confirm previous determinations that the traditional subsistence fish consumption rate is 500 pounds per capita annually, or 620 g per day (gpd). Lower comtemporary consumption rates for other population subsets are also discussed. The causes of the current suppression of fish consumption are discussed and the cultural, educational, social, and trade and economic impacts of the loss of fish are considered. Action levels for mercury for riverine Tribes in the Columbia Basin are suggested at 0.1 ppm or less based on the combined risk from mercury plus other contaminants, the higher fish consumption rates, the existing cultural deficit due to loss of salmon and other stressors, the health benefits of fish, and the cultural and economic importance of fish. The goal of fish advisories is to reduce fish consumption even further, which shifts the burden of avoiding risk to the very people who already bear the burdens of contaminant exposure, socio-economic impacts and cultural loss. However, because Tribal communities often do not have the choice of giving up more food, income, religion, culture, and heritage in order to avoid contamination, they are forced into choosing between culture and health. Many tribal members choose to incur chemical risk rather than giving up their culture and religion. We believe that lowering the action level for mercury is part of the federal fiduciary responsibility to American Indian Tribes.     

Which Fish Should I Eat? Perspectives Influencing Fish Consumption Choices

Background: Diverse perspectives have influenced fish consumption choices.Objectives: We summarized the issue of fish consumption choice from toxicological, nutritional, ecological, and economic points of view; identified areas of overlap and disagreement among these viewpoints; and reviewed effects of previous fish consumption advisories.Methods: We reviewed published scientific literature, public health guidelines, and advisories related to fish consumption, focusing on advisories targeted at U.S. populations. However, our conclusions apply to groups having similar fish consumption patterns.Discussion: There are many possible combinations of matters related to fish consumption, but few, if any, fish consumption patterns optimize all domains. Fish provides a rich source of protein and other nutrients, but because of contamination by methylmercury and other toxicants, higher fish intake often leads to greater toxicant exposure. Furthermore, stocks of wild fish are not adequate to meet the nutrient demands of the growing world population, and fish consumption choices also have a broad economic impact on the fishing industry. Most guidance does not account for ecological and economic impacts of different fish consumption choices.Conclusion: Despite the relative lack of information integrating the health, ecological, and economic impacts of different fish choices, clear and simple guidance is necessary to effect desired changes. Thus, more comprehensive advice can be developed to describe the multiple impacts of fish consumption. In addition, policy and fishery management inter-ventions will be necessary to ensure long-term availability of fish as an important source of human nutrition.     

Sport fish consumption advisories and projected cancer risks in the Great Lakes basin.

Because Great Lakes sport fish are contaminated with several toxicants, the Great Lakes states individually issue advisories, principally based on Food and Drug Administration (FDA) action levels, that suggest limiting or eliminating consumption of contaminated fish. We describe the procedures the states use to determine when to issue consumption advisories and we evaluate the associated cancer risks using EPA-IARC-OSTP risk assessment procedures. Projected cancer risks are high for consumers of small quantities of sport fish contaminated with DDT or dieldrin at their respective action levels. Projected risks at concentrations that are common but below the action levels are also substantial. We propose that sport fish with tissue concentrations of DDT or dieldrin one-fifth and one-third of the action levels should be covered by consumption advisories to warn consumers of the potential adverse health impacts.     

Fish intake guidelines: incorporating n-3 fatty acid intake and contaminant exposure in the Korean and Japanese communities

BACKGROUND: Fish consumption advisories are developed to prevent overexposure to various contaminants. Recently, discussion has centered on the need to consider the benefits of fish consumption alongside possible risks when providing guidance. OBJECTIVE: As part of the Arsenic Mercury Intake Biometric Study involving the Japanese and Korean communities living in Washington State, we obtained fish and nutrient intake data. Japanese and Korean women of childbearing age (n = 214) participated in this longitudinal study. We used these data, along with hair-mercury data to determine the need for both the nutritional benefits and concern about contaminants to be included when providing guidance. DESIGN: We examined the intake of 2 n-3 long-chain fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), found in fish and associated with a variety of beneficial health effects. Intakes of these lipids were used as surrogates to characterize the beneficial effect from fish consumption, and the intake of mercury was used to establish the risk from consumption. RESULTS: These 2 populations provided an ideal basis from which to examine this issue because their fish consumption rates were identical and higher than national rates, but their mercury intakes vary substantially because of different consumption behaviors. Results indicate that basing fish consumption guidelines on contaminant concentrations alone can have the unintended consequence of causing a portion of the population to have inadequate intake of required nutrients. CONCLUSION: Public health goals may be better served if nutritional elements and contaminant concerns are quantitatively incorporated into fish consumption guidelines.     

Exposure assessment and initial intervention regarding fish consumption of tribal members of the Upper Great Lakes Region in the United States

The Ojibwe Health Study (OHS) has concluded 10 years of data collection and exposure assessment. Eight hundred and twenty-two participants from tribes in the states of Wisconsin, Michigan, and Minnesota (USA) completed fish consumption and environmental risk perception questionnaires. Many participants provided hair and blood samples for mercury and polychlorinated biphenyl (PCB) residue analyses as body burden indicators of these persistent environmental pollutants. Fish were collected by the tribal organizations and contaminants were analyzed for numerous tribal reports and professional environmental journal articles, these data were used by the Great Lakes Indian Fish and Wildlife Commission to produce tribal-specific geographic information systems maps as part of a public health intervention strategy. These maps are currently available at for six Wisconsin tribes that regularly harvest walleye. To determine the health impacts (if any) of pollutants on cancer, diabetes, and reproduction, it was necessary to know the recent trends in key indicators such as cancer mortality ratios and birth gender ratios. The Great Lakes Inter-Tribal Council provided the OHS and each participating tribe in Wisconsin and Michigan with a health profile. Total fish consumption (estimated by recall) for 720 tribal participants was self-reported as 60 g/day, but the highest actual consumption was measured as 11.2 g/day in one of the tribal groups. The highest blood concentrations in tribal participants were 18.6 ppb total serum PCBs and 11.8 ppb total blood mercury. Ninety percent of the participants had less than 3.8 ppb total serum PCBs and 2.6 ppb total blood mercury. Compared to other studies of subsistence fishing populations, these exposures were only moderately elevated and not high enough to warrant widespread restrictions on diets. Furthermore, the benefits of eating a fish diet must be continually emphasized. However, sport fishermen and their families who consume larger and more contaminated fish should abide by their state fish consumption advisories to minimize their health risks.     

Daily consumption of wild fish and game: exposures of high end recreationists

There has been widespread interest in the exposure of indigenous and subsistence populations to a variety of contaminants through the consumption of wild fish and game, yet there is little information on recreationists. Information on wild fish and game consumption in South Carolina are presented here, data on other sources of animal protein are presented elsewhere. Data are presented for use in probabilistic risk assessment. Fish and deer were the most commonly eaten wild-caught foods. High-end consumers were eating at nearly 10x the median consumption rate for most wild-caught foods. There were significant differences in consumption as a function of age and ethnicity that should be taken into account when conducting risk assessments for the consumption of wild-caught meat and fish. Men consumed more of these foods, while white sportsmen consumed more deer and black sportsmen consumed more fish. Similar data are not generally available, either for the U.S. as a whole, or for specific geographical locations, although there are data for self-caught fish because of the issuance of consumption advisories for U.S. waters.     

Consumption advisories for salmon based on risk of cancer and noncancer health effects

The levels of dioxins/furans, polychlorinated biphenyls (PCBs), and chlorinated pesticides were determined in farmed salmon for eight regions in Europe, North America, and South America, in salmon fillets purchased in 16 cities in Europe and North America, and in five species of wild Pacific salmon. Upon application of US Environmental Protection Agency (USEPA) methods for developing fish consumption advisories for cancer from mixtures of all of these substance for which USEPA has reported a cancer slope factor, the most stringent recommendation, for farmed salmon from northern Europe, was for consumption of at most one meal every 5 months in order to not exceed an elevated risk of cancer of more than 1 in 100,000. Farmed salmon from North and South America triggered advisories of between 0.4 and one meal per month. Retail market samples, in general, reflected levels found in regionally farmed fish, although much of the US salmon comes from Chile, which had somewhat lower contaminant levels than the North American farmed samples. Upon consideration of all of these organochlorine compounds as a mixture, even wild Pacific salmon triggered advisories of between one and less than five meals per month. The advisories are driven by the non-dioxin-like PCBs and pesticides and not by dioxins/furans and coplanar PCBs. For noncancer effects for contaminants where USEPA has provided a reference dose only endrin and PCBs triggered any significant advisory. For both of these in the worst case, farmed salmon from northern Europe, the advice was not more than three meals per month.     

Fishing, fish consumption, and awareness about warnings in a university community in central New Jersey in 2007, and comparisons with 2004

Fish are a healthy source of protein, but the risks from consuming fish have become a national concern. Over the past 7 years, there have been a number of national advisories regarding saltwater fish. Fish consumption patterns and public knowledge about advisories and warnings have been examined for at-risk populations, but there is little information about the latter for a general population, or of temporal trends in such information acquisition. Information about the benefits and health risks of consuming fish, health warnings from the New Jersey Department of Environmental Protection and the Food and Drug Administration, belief in these warnings, and trust in different sources of information were examined in a sample of 460 people within a university community in central New Jersey in 2007. The null hypothesis of no differences in fishing, consumption, and knowledge about advisories as a function of age, gender, ethnicity, and education was tested. In 2007, only 30% of the study population fished, and 83% of the study population ate fish, either commercial or self-caught. There were differences in fishing behavior, consumption patterns, and awareness of advisories as a function of gender, ethnicity, age, and education. Most notably, nearly twice as many men as women fished, Whites fished more and Blacks and Indian/Pakistanis fished less than other ethnic groups, and people aged 23-35 fished more than did others. About 8% of fish meals were from self-caught fish, 32% were eaten in restaurants, and 60% were of fish bought in stores and cooked at home. Men ate more meals of self-caught fish than did females, and Asians ate more meals of fish in restaurants, and Blacks ate more meals of store-bought fish than other ethnic groups. The total number of fish meals consumed per month increased significantly with age. Overall, more people had heard about the benefits (92%) than the risks (78%) of fish consumption. When asked whom they trust for information about health benefits and risks from eating fish, doctors were rated the highest, followed by professors; friends and fishermen were rated the lowest. We then examined whether there were any changes from 2004 to 2007 in the knowledge of the health benefits and warnings about fish consumption, and the trustworthiness of different sources of information. In other words, have communication efforts of the state and federal agencies resulted in any appreciable increase in overall awareness of the benefits or risks of fish consumption. The greatest change in the parameters examined from 2004 to 2007 was an overall decrease in fish consumption from an average of 7.9 meals per month in 2004 to about six meals per month in 2007. This suggests that the unintended effect of some of the warnings and advisories is to decrease overall fish consumption, rather than to switch from fish species with high levels of contaminants to those with low levels.     

An approach for quantitatively balancing methylmercury risk and omega-3 benefit in fish consumption advisories

Background: Nearly all fish consumption advisories for methylmercury (MeHg) are based only on risk. There is a need to also address benefits, especially those from polyunsaturated fatty acids (PUFAs), in neurodevelopmental function and cardiovascular health. However, because MeHg and PUFA generally act on these same end points, disentangling risk and benefit is challenging.Objectives: We propose an approach for balancing risk and benefit that is based on the use of statistically dissociated measures of risk and benefit.Discussion: Because of mutual coexposure of MeHg and PUFAs in population-based studies and their opposite effect on many of the same end points, MeHg risk and PUFA benefit are tightly linked statistically, which results in mutual (negative) confounding. Thus, neither MeHg risk nor PUFA benefit can be accurately quantified without taking the other into account. A statistical approach that generates unconfounded risk and benefit coefficients for each end point can permit their subsequent recombination to describe the overall risk–benefit profile of each species of fish or fish diet. However, it appears that some end points may be adversely affected by MeHg without experiencing counterbalancing benefit from PUFAs. Such end points may drive consumption advisories and may preclude balancing of risk and benefit on the basis of other end points.Conclusions: Our thinking about fish consumption advisories now recognizes the need to balance risk and benefit. However, although statistical analysis of the appropriate data can eliminate mutual confounding, care is required to address the most sensitive end points that may be sensitive to risk and not benefit.     

Awareness of Fish Advisories and Mercury Exposure in Women of Childbearing Age

Methylmercury crosses the placenta and increases the risk of impaired neurodevelopment in the fetus. Federal guidelines for fish intake and fish advisories are in place to help people of all ages limit their exposure to mercury from fish. However, recent studies suggest that the awareness of fish advisories is low among women of childbearing age. Fish intake is strongly correlated with hair mercury concentrations. In women in states with fish advisories, hair mercury concentrations were 7-fold higher in women who consumed 20 or more servings offish than in those who reported no fish consumption in the past 3 months (0.59 vs. 0.08 μg/g). Among this high fish consumption group, the 75th and 95th percentile of hair mercury concentrations were 0.99 and 2.29 μg/g, respectively. This is of concern because the US Environmental Protection Agency (EPA) recommends that hair mercury be less than 1 μg/g. Public health campaigns to reduce mercury exposure need further refinement to reach women of childbearing age.     

Mercury levels and fish consumption practices in women of child-bearing age in the Florida Panhandle

The southeastern United States, and in particular the coastal areas along the Gulf of Mexico (Gulf Coast) in Florida, experience some of the highest levels of mercury deposition in the country. Although the State of Florida's coastal border is among the longest in the United States, and the State has issued fish consumption advisories due to mercury on multiple fish species, few data have been systematically collected to assess mercury levels in the human population of the state or to assess the efficacy of the consumption advisories. Because of the generally high rate of seafood consumption among coastal populations, the human population in the Florida Panhandle, near Pensacola, FL is potentially exposed to elevated levels of mercury. In the present study, we analyzed hair mercury levels in women of child-bearing age (16-49 years) who had resided near Pensacola, FL for at least 1 year. We also surveyed the fish consumption practices of the cohort and evaluated awareness of the Florida Fish Consumption Advisory. Hair mercury levels were significantly higher in women who consumed fish within the 30 days prior to sampling (p<0.05) and in those women who were unaware of the consumption advisory (p<0.05). Only 31% of the women reported knowledge of the consumption advisory and pregnant women exhibited lower awareness of the advisory than non-pregnant women. The data suggest that public health interventions such as education and fish advisories have not reached the majority of women in the counties surrounding Pensacola who are most at risk from consumption of fish with high levels of mercury.     

Perceptions of the risks and benefits of fish consumption: Individual choices to reduce risk and increase health benefits

Studies of fish consumption often focus on awareness of and adherence to advisories, how much fish people eat, and contaminant levels in those fish. This paper examines knowledge and accuracy of risks and benefits of fish consumption among fishers and other recreationists in the New York Bight, indicative of whether they could make sound dietary decisions. While most respondents knew about health risks (70%) and benefits (94%) of consuming fish, far fewer could name specific risks and benefits. Less than 25% of respondents mentioned mercury and less than 15% mentioned that pregnant women and children were at risk. Far fewer people mentioned polychlorinated biphenyls (PCBs). Nearly 70% said it was healthy to eat fish, and 45% were aware that fish were rich in healthful oils. Despite the lack of details about what specific risks and benefits of fish, well over a third did not feel they needed more information. Other respondents had basic questions, but did not pose specific questions about the fish they caught or ate that would have clarified their individual risk-balancing decisions. Knowledge of which fish were high in contaminants did not match the mercury or PCB levels in those fish. There was a disconnect between the information base about specific risks and benefits of fish consumption, levels of mercury and PCBs in fish, and the respondent's desire for more information. These data indicate that respondents did not have enough accurate information about contaminants in fish to make informed risk-balancing decisions.