title: A quantitative risk-benefit analysis of changes in population fish consumption.
abstract: Although a rich source of n-3 polyunsaturated fatty acids (PUFAs) that may confer multiple health benefits, some fish contain methyl mercury (MeHg), which may harm the developing fetus. U.S. government recommendations for women of childbearing age are to modify consumption of high-MeHg fish, while recommendations encourage fish consumption among the general population because of nutritional benefits. To investigate the aggregate impacts of hypothetical shifts in fish consumption, the Harvard Center for Risk Analysis convened an expert panel (see acknowledgements). Effects investigated include prenatal cognitive development, coronary heart disease mortality, and stroke. Substitution of fish with high MeHg concentrations with fish containing less MeHg among women of childbearing age yields substantial developmental benefits and few negative impacts. However, if women instead decrease fish consumption, countervailing risks substantially reduce net benefits. If other adults (mistakenly and inappropriately) also reduce their fish consumption, the net public health impact is negative. Although high compliance with recommended fish consumption patterns can improve public health, unintended shifts in consumption can lead to public health losses. Risk managers should investigate and carefully consider how populations will respond to interventions, how those responses will influence nutrient intake and contaminant exposure, and how these changes will affect aggregate public health.
authors.affiliation: Harvard Center for Risk Analysis, Harvard School of Public Health, Boston, Massachusetts 02115, USA. cohenj@hsph.harvard.edu
authors.forename: Joshua T
authors.initials: JT
authors.lastname: Cohen
authors.forename: David C
authors.initials: DC
authors.lastname: Bellinger
authors.forename: William E
authors.initials: WE
authors.lastname: Connor
authors.forename: Penny M
authors.initials: PM
authors.lastname: Kris-Etherton
authors.forename: Robert S
authors.initials: RS
authors.lastname: Lawrence
authors.forename: David A
authors.initials: DA
authors.lastname: Savitz
authors.forename: Bennett A
authors.initials: BA
authors.lastname: Shaywitz
authors.forename: Steven M
authors.initials: SM
authors.lastname: Teutsch
authors.forename: George M
authors.initials: GM
authors.lastname: Gray
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D002490:Central Nervous System / Q000187:drug effects; D003327:Coronary Disease / Q000401:mortality / Q000517:prevention & control; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D005260:Female; D047109:Fetal Development / Q000187:drug effects; D006801:Humans; D008297:Male; D008767:Methylmercury Compounds / Q000633:toxicity*; D008954:Models, Biological; D018673:Nutrition Policy; D019057:Quality-Adjusted Life Years; D018570:Risk Assessment; D017747:Seafood / Q000009:adverse effects / Q000706:statistics & numerical data*; D020521:Stroke / Q000401:mortality / Q000517:prevention & control; D014481:United States
chemical_list: D015525:Fatty Acids, Omega-3; D008767:Methylmercury Compounds