A Public Health Response to Mercury in Fish

Suzanne K. Condon, Assistant CommissionerBureau of Environmental Health Assessment

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

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.

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.

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.

Mercury: Low Dose Health Effects

The fetus is much more sensitive than the The fetus is much more sensitive than the adult. Health effects in children include:adult. Health effects in children include:

I.Q. deficitsI.Q. deficits Delayed developmental milestonesDelayed developmental milestones Impaired motor functionImpaired motor function Attention and behavioral problemsAttention and behavioral problems Decreased visuospatial performanceDecreased visuospatial performance

Mercury in Fish in Massachusetts

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.

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.

Planned Follow-up Outreach Activities

Mailings to community health centers, local Mailings to community health centers, local health officials and health care providers.health officials and health care providers.

Coordination with WIC program.Coordination with WIC program. Grand Round programs at Massachusetts Grand Round programs at Massachusetts

hospitals with a focus on OB/GYN and hospitals with a focus on OB/GYN and pediatricians.pediatricians.

Coordination with various media outlets.Coordination with various media outlets. Various advertising initiatives (e.g. MBTA)Various advertising initiatives (e.g. MBTA)