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March 2005, Vol 95, No. 3 | American Journal of Public Health 393-397
© 2005 American Public Health Association
DOI: 10.2105/AJPH.2004.042879

POLICY, BIOLOGY, AND HEALTH

Human Biomonitoring to Optimize Fish Consumption Advice: Reducing Uncertainty When Evaluating Benefits and Risks

Scott M. Arnold, PhD, Tracey V. Lynn, DVM, MS, Lori A. Verbrugge, PhD and John P. Middaugh, MD

At the time this article was written, all the authors were with the Alaska Division of Public Health, Section of Epidemiology, Anchorage, Alaska.

Correspondence: Requests for reprints should be sent to Scott M. Arnold, PhD, Alaska Division of Public Health, Section of Epidemiology, 3601 C St, Ste 540, PO Box 240249 Anchorage, AK 99524–0249 (e-mail: scott_arnold{at}health.state.ak.us).

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.






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