Imm et al. selected among those in each household. The survey found that 50% of consumers of GL sport-caught ﬁsh were aware of the consump- tion advisory issued by their state of residence (Tilden et al. 1997). Awareness rates varied by gender and race and were lowest among women and minorities. Those results prompted a reevaluation of GL sport-caught ﬁsh advisory programs. Previously, information was targeted almost exclusively to anglers who were predominantly male, but in recognition that advice was not reaching women or minorities, the consortium expanded program outreach materials speciﬁcallly to include mate- rials targeted to women of childbearing age. Although the focus of the consortium was on PCB and DDE in GL ﬁsh, each state also pro- vided consumption advice for ﬁsh caught from inland lakes and rivers based on PCB and methylmercury ﬁsh tissue levels. Between June 2001 and June 2002 the consortium conducted a follow-up randomized telephone survey of 4,106 adults to evaluate changes in awareness and fish consumption patterns among residents of these states. In this article we summarize ﬁndings from that survey and changes that occurred between the 1993 and 2001 surveys. Materials and Methods Between June 2001 and June 2002 a popula- tion-based, random-digit-dial telephone survey of adults (≥ 18 years of age) residing in Indiana, Illinois, Minnesota, Michigan, New York, Ohio, Pennsylvania, and Wisconsin was con- ducted by the Wisconsin Survey Research Table 1. Fish consumption patterns among Great Lakes Basin residents. No. of respondents (%) % Weighted population that consumes: Any type of ﬁsh Tuna Sport-caught ﬁsh GL sport ﬁsh Demographic characteristic Age (years) 18–34 35–44 ≥ 45 Gender Male Female Race White Black Other/unknown Education Less than high school High school graduate Some college College graduate Household income ($) < 15,000 15,000–24,999 25,000–34,999 35,000–49,999 ≥ 50,000 Unknown State Illinois Indiana Michigan Minnesota New York Ohio Pennsylvania Wisconsin Total 1,040 (25) 904 (22) 2,065 (50) 1,801 (44) 2,305 (56) 3,539 (86) 259 (6) 302 (8) 386 (9) 1,412 (34) 995 (24) 1,295 (32) 488 (12) 447 (11) 432 (11) 723 (18) 1,255 (31) 761 (18) 508 (12) 513 (13) 502 (12) 510 (12) 516 (13) 529 (13) 508 (12) 512 (12) 4,106 (100%) 77 88 87 85 83 85 84 78 72 80 87 90 71 86 84 86 89 81 86 80 82 84 85 83 86 87 84% 63 15 7 16 Laboratory (Madison, Wisconsin). This study was designed as a follow-up to the 1993–1994 study conducted in these states and involved 4,106 adults who were randomly selected from each household. Although the same basic sur- vey instrument was used as a follow-up to the original survey, a new random sample among adult residents of these states was drawn. The total sample size was nearly half that of the original 1993–1994 study because of funding restraints. The overall Conference of American Survey Research Organizations (CASRO) response rate was 56% (CASRO 1982). Trained telephone interviewers used stan- dardized questionnaires to collect information on demographic characteristics and ﬁsh con- sumption during the preceding 12 months. Respondents were asked about their ﬁsh con- sumption habits in a stepwise pattern. Those who included fish in their diets were asked about sport-caught ﬁsh ingestion, speciﬁcally, any ﬁsh not purchased that was caught by the respondent or by someone else and given to the respondent. Fish purchased at a restaurant or store did not qualify as sport caught. Sport- caught fish consumers were asked about GL sport-caught ﬁsh intake, and consumers of GL sport-caught fish were asked about advisory awareness. GL sport-caught ﬁsh included ﬁsh caught in the mouths of rivers that feed into the Great Lakes. Because of the popularity of tuna in the U.S. diet and recent concerns regarding tuna as a source of mercury expo- sure, this survey also included a series of ques- tions about tuna (any type) consumption, which the original 1993–1994 survey did not include. Consumers of “commercial ﬁsh only” were deﬁned as ﬁsh consumers who reported eating no sport-caught fish in the previous 12 months. In this article commercial fish includes any type of tuna. However, where tuna is speciﬁcally referenced, it refers only to this type of commercial ﬁsh and no other. Statistical analysis of prevalence estimates, odds ratios, and chi-square and t-tests were con- ducted using SAS statistical software (version 9.1 for Windows; SAS Institute Inc., Cary, NC). Survey data were weighted before analysis to reﬂect state-speciﬁc selection probability for each household and adjusted for the number of telephone lines serving the residence using 2000 Census data. Data from each state were weighted to reﬂect the population age (four age groups were used) and gender distribution. Results Demographic characteristics of the sample. Of the 4,106 Great Lakes Basin residents who par- ticipated in this random-digit-dial telephone survey, 56% were female, 86% reported their race as white, 91% were high school graduates, and 50% were ≥ 45 years of age (Table 1). By design, the sample was stratified such that approximately 500 residents were sampled in 59 74 73 66 72 71 60 59 54 64 72 77 54 68 69 69 77 66 68 64 68 69 75 62 71 70 69% 44 46 53 0 19 29 22 26 19 23 19 15 22 23 24 20 14 22 23 24 26 18 24 21 25 44 15 21 16 39 22% 28 22 35 0 7 10 6 8 6 7 10 4 7 7 8 7 4 5 6 8 9 5 5 4 16 8 3 12 3 10 7% Type of ﬁsh consumed Commercial ﬁsh only (no sport ﬁsh) Non-GL sport ﬁsh (may include commercial ﬁsh) GL sport ﬁsh (may include commercial and/or non-GL sport ﬁsh) None 2,442 685 299 628 Percentages within groups may not total 100% because of rounding error. Percentages are based on weighted data. There were missing values for state, age, and education demographics because of partial completion of survey or refusal. Table 2. Fish consumption and average number of ﬁsh meals by type of ﬁsh eaten. No. of respondents % Who consume Average no. of ﬁsh meals per year Average no. of tuna meals per year Percentages and averages are based on weighted data. Average number of ﬁsh meals per year is calculated based on any and all types of ﬁsh, including tuna. 1326 VOLUME 113 | NUMBER 10 | October 2005 • Environmental Health Perspectives