A Public Health Response to Mercury in Fish

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A Public Health Response to Mercury in Fish

• Suzanne K. Condon, Assistant Commissioner
• Bureau of Environmental Health Assessment

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Outline of Presentation

• Introduction to mercury in fish and public health
  intervention.
  
• Issuance of 1994 statewide advisory
• Increasing evidence of pollution and health
  effects
  
• Mass Mercury Reduction Plan - DPH focus on
  Merrimack Valley
  
• Expanded Statewide Advisory

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1986 Sudbury River Advisory

• Mercury levels in Sudbury River fish prompts the
  1st MDPH advisory.
  
• The general public was advised not to consume any
  fish from this water body.
  
• The advisory covered the length of the Sudbury
  River from Ashland, MA to its confluence with the
  Assabet and Concord Rivers.
  
• Contamination thought to be related to Nyanza
  Superfund Site.

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1994 Statewide Fish Advisory

• Pregnant women are advised of the possible health
  risks from eating fish from Massachusetts
  freshwater bodies in order to prevent exposure of
  the developing fetus to mercury.
• MDPH continued to recognize the substantial
  benefits of fish consumption by the general
  population.
  
• The advisory did not apply to fish stocked in
  freshwater bodies by Division of Fish and
  Wildlife.

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Mercury Studies

• Faroe Islands Study (1999)
• located between Iceland and Scotland.
• High dependence on seafood based diet.
• Low dose exposure to pregnant women.
• Health effects observed in their children.

• New Zealand Study
• (1989)
• Seafood based diet.
• Low dose exposure to pregnant women.
• Health effects observed in their children.
• Children exhibited effects years after exposure
  ended.

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Mercury Low Dose Health Effects

• The fetus is much more sensitive than the adult.
  Health effects in children include
  
• I.Q. deficits
• Delayed developmental milestones
• Impaired motor function
• Attention and behavioral problems
• Decreased visuospatial performance

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Mercury in Fish in Massachusetts
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Focus on the Merrimack Valley

• Subsistence fishing, especially among immigrant
  and minority populations.
  
• Focus on subsistence fishers and their families.
• Grand Rounds at the Community Health Centers
  physicians, nurses, health educators.
  
• Focus group meetings with immigrant and minority
  residents.
  
• Outreach to local health departments.

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2001 Expanded Fish Advisory

• Expanded 1994 Statewide Advisory to include women
  of childbearing age, nursing mothers and children
  under 12 years old.
  
• Includes marine fish listed in recently released
  FDA advisory shark, swordfish, king mackerel,
  tilefish
  
• Massachusetts advisory includes tuna steak and
  advice on canned tuna.
  

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Planned Follow-up Outreach Activities

• Mailings to community health centers, local
  health officials and health care providers.
  
• Coordination with WIC program.
• Grand Round programs at Massachusetts hospitals
  with a focus on OB/GYN and pediatricians.
  
• Coordination with various media outlets.
• Various advertising initiatives (e.g. MBTA)