ALISON SCHERER
Comparative analysis of fish consumption advisories to pregnant women and women of childbearing age
Environmental Health, MS
Preceptor: Elaine Faustman, PhD
There is increasing interest in the integration of risks and benefits of fish consumption when formulating fish advisories. This integration is especially important when giving advice for potential at-risk populations such as pregnant women. Fish advisories are provided throughout the United States to protect the public from risks posed by toxic contaminants while public health officials encourage fish consumption on the basis of nutritional benefits. Over 3,000 fish consumption advisories are in effect in the United States. In general, most advisories are based on estimated risks from single contaminants and do not consider cumulative exposure from mixtures of contaminants or aggregate exposure from multiple sources in the total diet and often do not consider beneficial effects of fish consumption. Alternative sources of non-contaminated fish or protein sources are often not given in these fish consumption advisories. We have reviewed existing fish advisories provided to pregnant women and women of childbearing age. These advisories included no-consumption and/or restricted-consumption advisories for women of childbearing age issued by local, state or federal government. Approximately 98% of these advisories are due to five bioaccumulative contaminants, including mercury, polychlorinated biphenyls, chlordane, dioxins and dichloro-diphenyl-trichloroethane. However, few studies have methodically examined the impact of exposure to more than one toxicant or combination of risks nor have they integrated benefits from fish consumption. When pregnant women or women of childbearing age do follow fish consumption advice, they substitute their diets with other foods. Researchers and public health professionals have speculated about the health effects of diet substitution when fish advisories are followed, although little progress has been made to address this conundrum. Our research has identified common metrics used to estimate risks and benefits and we have identified key impediments that limit integrated public health messages for pregnant women.
