Human biomonitoring to optimize fish consumption advice: reducing uncertainty when evaluating benefits and risks.
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.
Arnold
Scott M
SM
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
Lynn
Tracey V
TV
Verbrugge
Lori A
LA
Middaugh
John P
JP
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
D004785:Environmental Pollutants; D008767:Methylmercury Compounds
JAMA. 2003 Apr 2;289(13):1667-74
12672735
J Nutr. 2003 May;133(5 Suppl 1):1539S-43S
12730461
J Expo Anal Environ Epidemiol. 1995 Jul-Sep;5(3):405-24
8814778
Int J Circumpolar Health. 2001 Apr;60(2):112-22
11507960
Int J Circumpolar Health. 1999 Apr;58(2):108-19
10429340
N Engl J Med. 2002 Apr 11;346(15):1113-8
11948270
Lancet. 2001 Jun 2;357(9270):1764-6
11403817
Lipids. 1996 Mar;31 Suppl:S167-76
8729114
Clin Perinatol. 1995 Mar;22(1):157-75
7781250
Exp Biol Med (Maywood). 2001 Jun;226(6):498-506
11395920
Alaska Med. 2002 Jan-Mar;44(1):2-7
11969137
Lancet. 2003 May 17;361(9370):1686-92
12767734
Science. 1997 Dec 12;278(5345):1904-5
9417640
Int J Circumpolar Health. 1998 Jan;57(1):4-17
9567571
Environ Health Perspect. 2003 Apr;111(4):576-8
12676618
J Expo Anal Environ Epidemiol. 2000 Nov-Dec;10(6 Pt 2):611-29
11138654
Cancer Epidemiol Biomarkers Prev. 2003 Jan;12(1):64-7
12540506
Curr Atheroscler Rep. 2001 Mar;3(2):174-9
11177663
Int J Circumpolar Health. 1999 Oct;58(4):254-71
10615831
MMWR Morb Mortal Wkly Rep. 2001 Mar 2;50(8):140-3
11393484
JAMA. 1998 Aug 26;280(8):701-7
9728641
Am J Clin Nutr. 1992 May;55(5):1024-32
1570796
Am J Clin Nutr. 1999 Jul;70(1):85-90
10393143
Am J Clin Nutr. 2001 Oct;74(4):464-73
11566644
Int J Obes Relat Metab Disord. 2000 Feb;24(2):171-9
10702767
J Am Coll Dent. 2014 Summer;81(3):4-13
25951677