Human biomonitoring to optimize fish consumption advice: reducing uncertainty when evaluating benefits and risks

Subsistence fish consumption in rural Alaska: Using regional monitoring data to evaluate risk and bioavailability of dietary methylmercury

On average, Alaskans in rural communities consume over three times the Federally recommended maximum weekly fish ingestion rate (IR), the overwhelming majority of which is Pacific salmon. Results of statewide monitoring efforts consistently show that Pacific salmon from Alaska have low concentrations of mercury, yet concerns regarding dietary exposure to methylmercury (MeHg) and other aquatic contaminants continue to contribute to declining subsistence fish consumption rates in rural communities. Therefore, the goal of the present study was to use statewide biomonitoring datasets and regional fish IRs to quantitatively evaluate potential risk from dietary MeHg exposure via subsistence consumption of salmon from Alaska. Hazard Indices (HIs) did not exceed 1 for any of the groups evaluated, indicating negligible risk for the average Alaskan subsistence consumer. Selenium health benefit values (HBV_Se) of various fish species from AK were also calculated, with positive results for all commonly consumed subsistence species. Additionally, mercury concentrations in the hair of Alaskan women were evaluated as a proxy for dietary MeHg exposure. Results reveal that Alaskan women of childbearing age have substantially lower hair Hg concentrations than their counterparts in other large-scale biomonitoring studies, despite similar fish IRs. Collectively, results of the present study suggest that MeHg in Pacific salmon does not pose an unacceptable hazard for the average subsistence consumer in Alaska.

Sustainable Seafood and Vegetable Production: Aquaponics as a Potential Opportunity in Urban Areas

Global population growth will increase pressures on current food systems in order to supply adequate protein and produce to the increasingly urban world population. The environmental impact of food production is a critical area of study as it influences water and air quality, ecosystem functions, and energy consumption. Aquaponics (in which seafood and vegetables are grown in a closed-loop system) has the potential to reduce the environmental impact of food production. A review of the current environmental and economic considerations is provided in order to identify current research gaps. Research gaps exist with respect to 1) diversity of aquatic and plant species studied; 2) inconsistent bounds, scope, and lifetime across studies; 3) diverse allocation of the environmental and economic impacts to the coproducts; 4) scale of systems considered; 5) transportation of produced food; and 6) presence of heavy metals, pests, and pathogens with human health implications. These aspects require increased attention to close the existing gaps prior to widescale deployment of these systems for increased sustainable food production toward satisficing human needs. Integr Environ Assess Manag 2019;00:1-12. © 2019 SETAC.

Fish for Dinner? Balancing Risks, Benefits, and Values in Formulating Food Consumption Advice

Many and complex factors underlie seemingly simple decisions about what to eat. This is particularly so for foods such as fish, which present consumers with both risks and benefits. Advice about what type of and how much fish to consume is abundant, but that advice is often confusing or contradictory, reflecting the differing mandates and orientations of those advising. We survey a range of issues that can and should be incorporated into dietary advice, and offer tools for health agencies tasked with providing it. We argue that risks and benefits should not be limited to direct physical health. Rather, socioeconomic and community factors, unintended or indirect effects, and nonhuman-health outcomes such as animal welfare and planetary health should also be considered and weighed. We provide examples of existing fish consumption guidance to highlight the conflicting messages that emerge when different sources of advice with singular aims of avoiding risk, gaining nutritional benefit, or sustaining fish populations are juxtaposed. We then offer tools borrowed from health and other fields to guide health agencies toward developing more comprehensive advice and targeting that advice for specific populations.

Low-level methylmercury exposure through rice ingestion in a cohort of pregnant mothers in rural China

BACKGROUND

Rice ingestion is an important dietary exposure pathway for methylmercury. There are few studies concerning prenatal methylmercury exposure through rice ingestion, yet the health risks are greatest to the developing fetus, and thus should be investigated.

OBJECTIVES

Our main objective was to quantify dietary methylmercury intake through rice and fish/shellfish ingestion among pregnant mothers living in southern China, where rice was a staple food and mercury contamination was considered minimal.

METHODS

A total of 398 mothers were recruited at parturition, who donated scalp hair and blood samples. Total mercury and/or methylmercury concentrations were measured in biomarkers, in rice samples from each participant's home, and in fish tissue purchased from local markets. Additional fish/shellfish mercury concentrations were obtained from a literature search. Dietary methylmercury intake during the third trimester was equivalent to the ingestion rate for rice (or fish/shellfish)×the respective methylmercury concentration.

RESULTS

Dietary methylmercury intake from both rice and fish/shellfish ingestion averaged 1.2±1.8µg/day (median=0.79µg/day, range=0-22µg/day), including on average 71% from rice ingestion (median: 87%, range: 0-100%), and 29% from fish/shellfish consumption (median 13%, range: 0-100%). Median concentrations of hair total mercury, hair methylmercury, and blood total mercury were 0.40µg/g (range: 0.08-1.7µg/g), 0.28µg/g (range: 0.01-1.4µg/g), and 1.2µg/L (range: 0.29-8.6µg/L), respectively, and all three biomarkers were positively correlated with dietary methylmercury intake through rice ingestion (Spearman's rho=0.18-0.21, p≤0.0005), although the correlations were weak. In contrast, biomarkers were not correlated with fish/shellfish methylmercury intake (Spearman's rho=0.04-0.08, p=0.11-0.46).

CONCLUSIONS

Among pregnant mothers living in rural inland China, rice ingestion contributed to prenatal methylmercury exposure, more so than fish/shellfish ingestion.

Daily intake of lead in Wistar rats at different ages: Biochemical, genotoxic and physiological effects

The effects of the daily intake of feed containing lead (2.0 mg Pb kg(-1)) were evaluated in 45 (Pb45) and 90 (Pb90)-day-old Wistar female rats. Compared to the respective control groups, Pb45 rats consumed more feed and showed greater weight gain, but these parameters returned to control values in Pb90 rats. Higher blood glucose levels were observed in both Pb groups, whereas plasma insulin concentrations were higher in Pb45 but lower in the Pb90 group. Liver glycogen content was lower only in the Pb90 rats. There were no changes in plasma cortisol and acetylcholinesterase activity in the brain. Hematological alterations were observed only in Pb90 rats, which showed lower hemoglobin levels. In the liver, Pb45 rats showed decreased catalase and glutathione peroxidase activities and increased glutathione reductase activity, but in the Pb90 group, glutathione levels were higher. Increased hepatic lipid peroxidation and DNA damage in the lymphocytes were observed in both Pb groups. These results indicate that the daily intake of Pb for different periods results in metabolic changes and in the establishment of oxidative and genotoxic damage in female rats.

Global methylmercury exposure from seafood consumption and risk of developmental neurotoxicity: a systematic review

OBJECTIVE

To examine biomarkers of methylmercury (MeHg) intake in women and infants from seafood-consuming populations globally and characterize the comparative risk of fetal developmental neurotoxicity.

METHODS

A search was conducted of the published literature reporting total mercury (Hg) in hair and blood in women and infants. These biomarkers are validated proxy measures of MeHg, a neurotoxin found primarily in seafood. Average and high-end biomarkers were extracted, stratified by seafood consumption context, and pooled by category. Medians for average and high-end pooled distributions were compared with the reference level established by a joint expert committee of the Food and Agriculture Organization (FAO) and the World Health Organization (WHO).

FINDINGS

Selection criteria were met by 164 studies of women and infants from 43 countries. Pooled average biomarkers suggest an intake of MeHg several times over the FAO/WHO reference in fish-consuming riparians living near small-scale gold mining and well over the reference in consumers of marine mammals in Arctic regions. In coastal regions of south-eastern Asia, the western Pacific and the Mediterranean, average biomarkers approach the reference. Although the two former groups have a higher risk of neurotoxicity than the latter, coastal regions are home to the largest number at risk. High-end biomarkers across all categories indicate MeHg intake is in excess of the reference value.

CONCLUSION

There is a need for policies to reduce Hg exposure among women and infants and for surveillance in high-risk populations, the majority of which live in low-and middle-income countries.

Biomonitoring of human fetal exposure to environmental chemicals in early pregnancy

The first trimester of human fetal life, a period of extremely rapid development of physiological systems, represents the most rapid growth phase in human life. Interference in the establishment of organ systems may result in abnormal development that may be manifest immediately or programmed for later abnormal function. Exposure to environmental chemicals may be affecting development at these early stages, and yet there is limited knowledge of the quantities and identities of the chemicals to which the fetus is exposed during early pregnancy. Clearly, opportunities for assessing fetal chemical exposure directly are extremely limited. Hence, this review describes indirect means of assessing fetal exposure in early pregnancy to chemicals that are considered disrupters of development. Consideration is given to such matrices as maternal hair, fingernails, urine, saliva, sweat, breast milk, amniotic fluid and blood, and fetal matrices such as cord blood, cord tissue, meconium, placenta, and fetal liver. More than 150 articles that presented data from chemical analysis of human maternal and fetal tissues and fluids were reviewed. Priority was given to articles where chemical analysis was conducted in more than one matrix. Where correlations between maternal and fetal matrices were determined, these articles were included and are highlighted, as these may provide the basis for future investigations of early fetal exposure. The determination of fetal chemical exposure, at the time of rapid human growth and development, will greatly assist regulatory agencies in risk assessments and establishment of advisories for risk management concerning environmental chemicals.

State calculations of cultural survival in environmental risk assessment: consequences for Alaska Natives

In 2007, the Alaska Division of Public Health issued their first-ever fish consumption advisory to reduce exposure to methylmercury. Interestingly, they utilized a toxicity level in their calculations of risk that is four times higher than the U.S. Environmental Protection Agency's (EPA) level, arguing that the EPA's calculation is "inappropriately restrictive" for Alaskans. This article explores the institutional reasoning and scientific calculations behind the state's fish consumption advice, with special attention paid to the consequences for Alaska Natives. I argue that a discourse of "Alaskan exceptionalism" is utilized by the health department to justify their assessment of risk. Although this exceptionalist discourse is intended to accommodate the unique lifestyles of Alaskan citizens, it may actually serve to undermine the very lifeways and traditions that it presumes to preserve. This article contributes insights into the ways that states can influence the social and material reproduction of communities through the deployment of "cultural difference" during the risk-assessment process.

Research into mercury exposure and health education in subsistence fish-eating communities of the Amazon basin: potential effects on public health policy

The neurotoxic effects of fish-methylmercury (meHg) consumed regularly are considered hazardous to fetuses and newborn infants; as a result fish consumption advisories are an important asset to control meHg exposure in affluent societies. These concerns are now part of health promotion programs for Amazon subsistence villagers. While urban dwellers in affluent societies can choose an alternative nutritious diet, traditional and subsistence communities are caught up in controversial issues and lifestyle changes with unintended health consequences. Traditional fish-eating populations of industrialized and non-industrialized regions may be exposed to different neurotoxic substances: man-made pollutants and environmentally occurring meHg. Additionally, in non-industrialized countries, pregnant women and infants are still being immunized with thimerosal-containing vaccines (TCVs) which degrade to ethylmercury (etHg). Therefore, the complexity involving fish-meHg associated with wild-fish choices and Hg exposure derived from TCVs is difficult to disentangle and evaluate: are villagers able to distinguish exposure to differently hazardous chemical forms of Hg (inorganic, fish-meHg, and injected etHg)? Is it possible that instead of helping to prevent a plausible (unperceived) fish-meHg associated neurocognitive delay we may inadvertently arouse panic surrounding Hg exposure and disrupt subsistence fish-eating habits (necessary for survival) and life-saving vaccination programs (required by public health authorities)? These questions characterize the incompleteness of information related on the various chemical forms of Hg exposure and the need to convey messages that do not disrupt nutritional balance and disease prevention policies directed at Amazonian subsistence communities.

Levels of polychlorinated biphenyls (PCBs) and three organochlorine pesticides in fish from the Aleutian Islands of Alaska

BACKGROUND

Persistent organic pollutants (POPs), including polychlorinated biphenyls (PCBs) and chlorinated pesticides, have been shown to have many adverse human health effects. These contaminants therefore may pose a risk to Alaska Natives that follow a traditional diet high in marine mammals and fish, in which POPs bioaccumulate.

METHODS AND FINDINGS

This study examined the levels of PCBs and three pesticides [p, p'-DDE, mirex, and hexachlorobenzene (HCB)] in muscle tissue from nine fish species from several locations around the Aleutian Islands of Alaska. The highest median PCB level was found in rock sole (Lepidopsetta bilineata, 285 ppb, wet weight), while the lowest level was found in rock greenling (Hexagrammos lagocephalus, 104 ppb, wet weight). Lipid adjusted PCB values were also calculated and significant interspecies differences were found. Again, rock sole had the highest level (68,536 ppb, lipid weight). Concerning the PCB congener patterns, the more highly chlorinated congeners were most common as would be expected due to their greater persistence. Among the pesticides, p, p'-DDE generally dominated, and the highest level was found in sockeye salmon (Oncorhynchus nerka, 6.9 ppb, wet weight). The methodology developed by U.S. Environmental Protection Agency (USEPA) was used to calculate risk-based consumption limits for the analyzed fish species. For cancer health endpoints for PCBs, all species would trigger strict advisories of between two and six meals per year, depending upon species. For noncancer effects by PCBs, advisories of between seven and twenty-two meals per year were triggered. None of the pesticides triggered consumption limits.

CONCLUSION

The fish analyzed, mainly from Adak, contain significant concentrations of POPs, in particular PCBs, which raises the question whether these fish are safe to eat, particularly for sensitive populations. However when assessing any risk of the traditional diet, one must also consider the many health and cultural benefits from eating fish.

Something fishy? News media presentation of complex health issues related to fish consumption guidelines

OBJECTIVE

The news media are an important source of dietary information. Understanding news content, particularly the portrayal of risks and benefits of certain foods, is relevant for effective public health communication. Fish consumption may reduce risk for CVD and aid neonatal development, but recent work shows public confusion about the benefits of fish, challenged by the evidence of mercury and other contaminants in fish. We present an analysis of the messages about fish in US news media over 15 years, identifying trends in coverage and highlighting implications of current messaging.

DESIGN

We conducted a descriptive text analysis and coded for manifest content: locality of focus, story frame, reference to studies, inclusion of government guidelines and portrayal of uncertainty. We identified chronological patterns and analysed the data for statistically significant relationships between media source and content.

SETTING

News stories were selected from five daily newspapers and five television networks (1993-2007).

SUBJECTS

We analysed 310 health-related news stories on fish.

RESULTS

Risk messages outweighed benefit messages four to one, and health benefits only became prominent after 2002. No difference existed in coverage topic by news source. Fish consumption has increasingly become a national issue.

CONCLUSIONS

With the bulk of messages about fish consumption focused on risk, the benefits may be lost to consumers. This gap creates a need for public health to work with news media to more effectively communicate benefits and risks around fish consumption and health and to consider options for communicating tailored information where it can be more readily utilised.

Hair mercury levels in Amazonian populations: spatial distribution and trends

BACKGROUND

Mercury is present in the Amazonian aquatic environments from both natural and anthropogenic sources. As a consequence, many riverside populations are exposed to methylmercury, a highly toxic organic form of mercury, because of their intense fish consumption. Many studies have analysed this exposure from different approaches since the early nineties. This review aims to systematize the information in spatial distribution, comparing hair mercury levels by studied population and Amazonian river basin, looking for exposure trends.

METHODS

The reviewed papers were selected from scientific databases and online libraries. We included studies with a direct measure of hair mercury concentrations in a sample size larger than 10 people, without considering the objectives, approach of the study or mercury speciation. The results are presented in tables and maps by river basin, displaying hair mercury levels and specifying the studied population and health impact, if any.

RESULTS

The majority of the studies have been carried out in communities from the central Amazonian regions, particularly on the Tapajós River basin. The results seem quite variable; hair mercury means range from 1.1 to 34.2 microg/g. Most studies did not show any significant difference in hair mercury levels by gender or age. Overall, authors emphasized fish consumption frequency as the main risk factor of exposure. The most studied adverse health effect is by far the neurological performance, especially motricity. However, it is not possible to conclude on the relation between hair mercury levels and health impact in the Amazonian situation because of the relatively small number of studies.

CONCLUSIONS

Hair mercury levels in the Amazonian regions seem to be very heterogenic, depending on several factors. There is no obvious spatial trend and there are many areas that have never been studied. Taking into account the low mercury levels currently handled as acceptable, the majority of the Amazonian populations can be considered exposed to methylmercury contamination. The situation for many of these traditional communities is very complex because of their high dependence on fish nutrients. It remains difficult to conclude on the Public Health implication of mercury exposure in this context.

Marine fish food in the United States and methylmercury risk

This paper takes a market-oriented approach to study potential exposure of methylmercury (MeHg) risk to human health from US domestic commercial ocean fish landings (consumption). Information is assembled on MeHg concentration levels of marine species. Landings were examined for 1995-2005. Confined to this seafood source, trends of landings indicating high concentration species (above 0.7 ppm, tilefish, shark, king mackerel and swordfish) were significantly decreased. People bought stable amount of medium MeHg level species (0.3-0.7 ppm, grouper, Spanish mackerel) but less amount of low concentration level species (below 0.3 ppm, catfish, tuna and southern flounder). Based on estimated prices of species and quantities taken it is found that consumers, one crucial link of the entire MeHg risk assessment process, had exhibited awareness of potential MeHg risk in fish and demonstrated in household fish consumption. Information assembled in this paper is insufficient to draw further inference on specific population cohorts more susceptible to potential exposure of MeHg risk. This inquiry may be extended to imported fish in the US for comparison.

Hair methylmercury levels of mummies of the Aleutian Islands, Alaska

Ancient human hair specimens can shed light on the extent of pre-historic exposures to methylmercury and provide valuable comparison data with current-day exposures, particularly for Indigenous Peoples who continue to rely upon local traditional food resources. Human hair from ancient Aleutian Island Native remains were tested for total and methylmercury (Hg, MeHg) and were radiocarbon dated. The remains were approximately 500 years old (1450 A.D.). For four adults, the mean and median total hair mercury concentration was 5.8 ppm (SD=0.9). In contrast, MeHg concentrations were lower with a mean of 1.2 ppm (SD=1.8) and a median of 0.54 ppm (0.12-3.86). For the five infants, the mean and median MeHg level was 1.2 ppm (SD=1.8) and 0.20 ppm (0.007-4.61), respectively. Segmental analyses showed variations in MeHg concentrations in 1-cm segments, consistent with fluctuations in naturally occurring exposure to mercury through dietary sources. The levels are comparable to or lower than those found in fish and marine mammal-eating populations today who rely far less on subsistence food than pre-historic humans. The findings are, therefore, compatible with increased anthropogenic release of trace metals during the past several centuries.

Meeting report: Methylmercury in marine ecosystems--from sources to seafood consumers

Mercury and other contaminants in coastal and open-ocean ecosystems are an issue of great concern globally and in the United States, where consumption of marine fish and shellfish is a major route of human exposure to methylmercury (MeHg). A recent National Institute of Environmental Health Sciences-Superfund Basic Research Program workshop titled "Fate and Bioavailability of Mercury in Aquatic Ecosystems and Effects on Human Exposure," convened by the Dartmouth Toxic Metals Research Program on 15-16 November 2006 in Durham, New Hampshire, brought together human health experts, marine scientists, and ecotoxicologists to encourage cross-disciplinary discussion between ecosystem and human health scientists and to articulate research and monitoring priorities to better understand how marine food webs have become contaminated with MeHg. Although human health effects of Hg contamination were a major theme, the workshop also explored effects on marine biota. The workgroup focused on three major topics: a) the biogeochemical cycling of Hg in marine ecosystems, b) the trophic transfer and bioaccumulation of MeHg in marine food webs, and c) human exposure to Hg from marine fish and shellfish consumption. The group concluded that current understanding of Hg in marine ecosystems across a range of habitats, chemical conditions, and ocean basins is severely data limited. An integrated research and monitoring program is needed to link the processes and mechanisms of MeHg production, bioaccumulation, and transfer with MeHg exposure in humans.

Maternal fish consumption in the nutrition transition of the Amazon Basin: growth of exclusively breastfed infants during the first 5 years

BACKGROUND

Changes in fish-eating habits due to rapid urbanization in Western Amazon was used as model to investigate whether maternal fish-intake rate impacts on children's weight and height during the first 5 years.

AIM

The study examined the growth of 82 breastfed children, and maternal fish consumption (hair mercury concentrations, HHg) during pregnancy and lactation.

SUBJECTS AND METHODS

Fish consumption in mothers and children was estimated through HHg. The children were measured and weighed at birth and at 6 (exclusive breastfeeding), 36 and 60 months.

RESULTS

Fish consumption rate (HHg) had no significant impact on children's growth at the specified ages (p = 0.35). After 6 months of exclusive breastfeeding, children had the highest proportion of Z-scores <-1 SD; however, weaning (with extended breastfeeding) had a substantial impact in moving up the attained growth at 3 years. The duration of breastfeeding was significantly correlated with attained Z-scores for weight-for-age (r = 0.26; p = 0.02) and weight-for-height (r = 0.22; p = 0.04) but not for height-for-age. At 3 years most children had improved Z-scores (>-1 SD) for height-for-age (70/82), weight-for-age (74/82) and weight-for-height (74/82). At 5 years, all but one child attained Z-scores >-1.

CONCLUSION

The apparently good nutritional status of subjects is more likely due to a well balanced diet composition than to only one dietary protein source--fish.

Epidemiologic confirmation that fruit consumption influences mercury exposure in riparian communities in the Brazilian Amazon

Since deforestation has recently been associated with increased mercury load in the Amazon, the problem of mercury exposure is now much more widespread than initially thought. A previous exploratory study suggested that fruit consumption may reduce mercury exposure. The objectives of the study were to determine the effects of fruit consumption on the relation between fish consumption and bioindicators of mercury (Hg) exposure in Amazonian fish-eating communities. A cross-sectional dietary survey based on a 7-day recall of fish and fruit consumption frequency was conducted within 13 riparian communities from the Tapajós River, Brazilian Amazon. Hair samples were collected from 449 persons, and blood samples were collected from a subset of 225, for total and inorganic mercury determination by atomic absorption spectrometry. On average, participants consumed 6.6 fish meals/week and ate 11 fruits/week. The average blood Hg (BHg) was 57.1 +/- 36.3 microg/L (median: 55.1 microg/L), and the average hair-Hg (HHg) was 16.8 +/- 10.3 microg/g (median: 15.7 microg/g). There was a positive relation between fish consumption and BHg (r = 0.48; P<0.0001), as well as HHg (r =0.34; P<0.0001). Both fish and fruit consumption entered significantly in multivariate models explaining BHg (fish: beta = 5.6, P<0.0001; fruit: beta = -0.5, P = 0.0011; adjusted model R2 = 36.0%) and HHg levels (fish: beta = 1.2, P<0.0001; fruit: beta = -0.2, P = 0.0002; adjusted model R2 = 21.0%). ANCOVA models showed that for the same number of fish meals, persons consuming fruits more frequently had significantly lower blood and HHg concentrations. For low fruit consumers, each fish meal contributed 9.8 microg/L Hg increase in blood compared to only 3.3 microg/L Hg increase for the high fruit consumers. In conclusion, fruit consumption may provide a protective effect for Hg exposure in Amazonian riparians. Prevention strategies that seek to maintain fish consumption while reducing Hg exposure in fish-eating communities should be pursued.

Omega-3 fatty acids and the benefits of fish consumption: is all that glitters gold?

In recent years, a number of studies have clearly remarked the nutritional benefits of fish consumption: proteins, vitamins, minerals, and especially omega-3 polyunsaturated fatty acids (PUFAs), which may protect against several adverse health effects, including coronary heart disease mortality and stroke. However, some concerns about potential health risks derived from the environmental contaminants found in fish have been also raised. Therefore, balancing adequately the risks and benefits of fish consumption is currently a nutritional/environmental health key issue. In this paper, the most recent available scientific information concerning this issue is reviewed. It is concluded that although it seems evident that fish must be an important part of a balanced diet, to choose the most suitable species in terms of levels of PUFAs and pollutants, the frequency of consumption, and the meal size are essential aspects to balance benefits and risks of a regular consumption.

Uses and issues of biomonitoring

In the last two decades, an explosion in information and literature on human biomonitoring data has occurred. Symposia, workshops, and workgroups have been formed to discuss all issues surrounding biomonitoring. One such workgroup, formed by the International Life Sciences Institute's Health and Environmental Sciences Institute (HESI), developed a wheel which has biomonitoring at its hub; its spokes depict the uses of biomonitoring. As it rolls and picks up speed, the biomonitoring wheel will no doubt gain additional spokes. In this manuscript, we describe and give examples of these biomonitoring uses and some of their further applications as well as some of the issues surrounding biomonitoring. Special emphasis is placed on the uses and limitations of large-scale representative cross sectional studies such as the National Health and Nutrition Examination Surveys in the United States. Priority setting, improved modeling methods for interpreting the biomonitoring data, and an increase in studies designed to associate health indicators and health risks to selected environmental chemicals are needed to increase the power of biomonitoring.

Benefits and risks of fish consumption

In recent years, and based on the importance of fish as a part of a healthy diet, there has been a notable promotion of fish and seafood consumption. However, a number of recent studies have shown that fish may be a potential source of exposure to chemical pollutants, some of them with well known adverse effects on human health. Recently, we determined in 14 edible marine species the concentrations of eicosapentaenoic acid (EPA) and docosohexaenoic acid (DHA), as well as those of a number of chemical contaminants: Cd, Hg, Pb, polychlorinated dibenzo-p-dioxins and furans, polychlorinated biphenyls, hexachlorobenzene, polycyclic aromatic hydrocarbons, polychlorinated naphthalenes, polybrominated diphenylethers and polychlorinated diphenylethers. To quantitative establish the intake of these pollutants (risks) versus that of EPA+DHA (benefits), we designed a simple computer program, RIBEPEIX. The concentrations of EPA, DHA, and the chemical pollutants were introduced into the program. We here present how RIBEPEIX may be used as an easy tool to optimize fish consumption: most suitable species, frequency of consumption, and size of meals. RIBEPEIX can be useful not only for professionals (cardiologists, general physicians, nutritionists, toxicologists, etc.), but also for the general population. It is available at: .

Maternal fish consumption, mercury levels, and risk of preterm delivery

BACKGROUND

Pregnant women receive mixed messages about fish consumption in pregnancy because unsaturated fatty acids and protein in fish are thought to be beneficial, but contaminants such as methylmercury may pose a hazard.

METHODS

In the Pregnancy Outcomes and Community Health (POUCH) study, women were enrolled in the 15th to 27th week of pregnancy from 52 prenatal clinics in five Michigan communities. At enrollment, information was gathered on amount and category of fish consumed during the current pregnancy, and a hair sample was obtained. A segment of hair closest to the scalp, approximating exposure during pregnancy, was assessed for total mercury levels (70-90% methylmercury) in 1,024 POUCH cohort women.

RESULTS

Mercury levels ranged from 0.01 to 2.50 pg/g (mean = 0.29 microg/g; median = 0.23 microg/g). Total fish consumption and consumption of canned fish, bought fish, and sport-caught fish were positively associated with mercury levels in hair. The greatest fish source for mercury exposure appeared to be canned fish. Compared with women delivering at term, women who delivered before 35 weeks' gestation were more likely to have hair mercury levels at or above the 90th percentile (> or = 0.55 microg/g), even after adjusting for maternal characteristics and fish consumption (adjusted odds ratio = 3.0; 95% confidence interval, 1.3-6.7).

CONCLUSION

This is the first large, community-based study to examine risk of very preterm birth in relation to mercury levels among women with low to moderate exposure. Additional studies are needed to see whether these findings will be replicated in other settings.