title: Human biomonitoring to optimize fish consumption advice: reducing uncertainty when evaluating benefits and risks.
abstract: National fish consumption advisories that are based solely on assessment of risk of exposure to contaminants without consideration of consumption benefits result in overly restrictive advice that discourages eating fish even in areas where such advice is unwarranted. In fact, generic fish advisories may have adverse public health consequences because of decreased fish consumption and substitution of foods that are less healthy. Public health is on the threshold of a new era for determining actual exposures to environmental contaminants, owing to technological advances in analytical chemistry. It is now possible to target fish consumption advice to specific at-risk populations by evaluating individual contaminant exposures and health risk factors. Because of the current epidemic of nutritionally linked disease, such as obesity, diabetes, and cardiovascular disease, general recommendations for limiting fish consumption are ill conceived and potentially dangerous.
authors.affiliation: Alaska Division of Public Health, Section of Epidemiology, 3601 C St, Ste 540, PO Box 240249 Anchorage, AK 99524-0249, USA. scott_arnold@health.state.ak.us
authors.forename: Scott M
authors.initials: SM
authors.lastname: Arnold
authors.forename: Tracey V
authors.initials: TV
authors.lastname: Lynn
authors.forename: Lori A
authors.initials: LA
authors.lastname: Verbrugge
authors.forename: John P
authors.initials: JP
authors.lastname: Middaugh
mesh_terms: D000293:Adolescent; D000328:Adult; D000413:Alaska / Q000453:epidemiology; D000818:Animals; D002623:Chemistry Techniques, Analytical / Q000639:trends; D003376:Counseling / Q000592:standards; D004784:Environmental Monitoring / Q000379:methods* / Q000592:standards; D004785:Environmental Pollutants / Q000009:adverse effects / Q000506:poisoning; D062665:Epidemiological Monitoring; D005260:Female; D005399:Fishes; D006197:Hair / Q000737:chemistry; D006801:Humans; D008403:Mass Screening; D008630:Mercury Poisoning / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D008767:Methylmercury Compounds / Q000009:adverse effects / Q000032:analysis / Q000506:poisoning; D008875:Middle Aged; D019055:No-Observed-Adverse-Effect Level; D018673:Nutrition Policy / Q000639:trends; D052756:Nutritional Sciences / Q000193:education; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control; D011634:Public Health / Q000592:standards / Q000639:trends; D018570:Risk Assessment; D012307:Risk Factors; D017747:Seafood / Q000009:adverse effects / Q000032:analysis / Q000506:poisoning; D035501:Uncertainty; D014481:United States; D014484:United States Environmental Protection Agency; D014486:United States Food and Drug Administration
chemical_list: D004785:Environmental Pollutants; D008767:Methylmercury Compounds
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