Research Fish Consumption and Advisory Awareness in the Great Lakes Basin Pamela Imm, Lynda Knobeloch, Henry A. Anderson, and the Great Lakes Sport Fish Consortium Division of Public Health, Wisconsin Department of Health and Family Services, Madison, Wisconsin, USA More than 61 million adults live in the eight U.S. states bordering the Great Lakes. Between June 2001 and June 2002, a population-based, random-digit-dial telephone survey of adults residing in Great Lakes (GL) states was conducted to assess consumption of commercial and sport-caught ﬁsh and awareness of state-issued consumption advisories for GL ﬁsh. On the basis of the weighted sur- vey data, approximately 84% of the adults living in these states included ﬁsh in their diets. Seven percent (an estimated 4.2 million adults) consumed ﬁsh caught from the Great Lakes. The percent- age of residents who had consumed sport-caught ﬁsh (from any water source) varied regionally and was highest among those who lived in Minnesota (44%) and Wisconsin (39%). Consumption of GL sport ﬁsh was highest among residents of Michigan (16%) and Ohio (12%). Among residents who had eaten GL ﬁsh, awareness of consumption advisories varied by gender and race and was lowest among women (30%) and black residents (15%). However, 70% of those who consumed GL sport-caught ﬁsh twice a month or more (an estimated 509,000 adults across all eight states) were aware of the advisories. Findings from this survey indicate that exposure to persistent contam- inants found in GL ﬁsh is likely limited to a relatively small subpopulation of avid sport-ﬁsh con- sumers. Results also underscore the public health importance of advisories for commercial fish because an estimated 2.9 million adults living in these states consume more than 104 ﬁsh meals per year and may be at risk of exceeding the reference doses for methylmercury, polychlorinated biphenyls, and other bioaccumulative contaminants. Key words: advisory, awareness, fish, Great Lakes, sport ﬁsh. Environ Health Perspect 113:1325–1329 (2005). doi:10.1289/ehp.7980 available via http://dx.doi.org/ [Online 13 June 2005] Consumption advisories for sport-caught ﬁsh were first issued by Great Lakes (GL) states during the 1970s. These advisories were based on ﬁndings from investigations of the methyl- mercury poisonings that had occurred in Minamata, Japan, and on ﬁsh tissue analysis. Since that time, researchers have discovered that a variety of other persistent environmental contaminants, including PCBs (polychlori- nated biphenyls), DDT (dichlorodiphenyl- trichloroethane), and polybrominated diphenyl ethers, had found their way into the aquatic food chain and might pose a risk to frequent consumers of large, predatory ﬁsh. Currently, health departments and/or state environmental agencies in 48 states issue consumption guide- lines for local sport-caught fish—fish that is caught and not purchased. The recent methylmercury reference dose revision from 0.5 gµ/kg/day to 0.1 gµ/kg/day triggered states to review their sport-ﬁsh advi- sories and federal agencies to assess the need for a commercial fish advisory. In 2004 the U.S. Environmental Protection Agency (EPA) and the U.S. Food and Drug Administration (FDA) jointly issued consumption advice for commercial ﬁsh that was intended to protect women of childbearing age and young chil- dren against the neurodevelopmental effects of methylmercury. It became apparent to some states that there was a need for a holistic methylmercury fish consumption advisory that combined advice forlocal sport-caught ﬁsh and commercial ﬁsh. Up until this time sport-caught fish advisories largely ignored exposures from commercial fish. Current advisories are intended to assist anglers and consumers of commercial ﬁsh in selecting ﬁsh low in chemical contaminants as part of a healthy, balanced diet. In 2001 an estimated 1.85 million ﬁsher- men purchased licenses to fish on the Great Lakes (U.S. Department of the Interior 2002). Although this figure reflects an almost 30% decline from 2.55 million in 1991, GL sport ﬁshing continues to be a popular recreational activity for many families. Frequent ingestion of fish from these lakes has been associated with higher body burdens of PCBs, DDT, and DDE (dichlorodiphenyldichloroethylene) (Anderson et al. 1998; Fiore et al. 1989; Humphrey 1983; Schwartz e al. 1983; Sonzogni et al. 1991; Tilden et al. 1997). These persistent contaminants accumulate in the body over time and increase the risk of a variety of health problems such as liver disease (Yu et al. 1997), reproductive (Dar et al. 1992; Weisskopf et al. 2003) and neurologic prob- lems (Rogan and Gladen 1992), endocrine changes (Braathen et al. 2004; Persky et al. 2001), and developmental delays (Jacobson et al. 1990; Jacobson et al. 1986; Kimbrough and Krouskas 2003; Longnecker et al. 1997; Tilson and Kodavanti 1998). PCBs, DDT, and DDE have been classified as probable human carcinogens by the U.S. EPA, and sport-fish consumption has recently been associated with an increased risk of breast can- cer among young, premenopausal women (McElroy et al. 2004). Environmental Health Perspectives • VOLUME 113 | NUMBER 10 | October 2005 Prenatal exposure to methylmercury has been associated with subtle learning delays and blood pressure changes (Grandjean et al. 1998; Sorenson et al. 1999). Methylmercury exposure during adulthood has recently been linked to higher rates of cardiovascular disease and acute myocardial infarction (Guallar et al. 2002; Salonen et al. 1995). Until the early 1990s sport-ﬁsh consump- tion advisories were developed independently by each state. Development of these advisories may have been based on policy considerations as well as science. This led to confusion because neighboring states often provided dif- ferent advice for the same, shared body of water. This situation was confusing for anglers and may have reduced conﬁdence in the advi- sories. At the direction of the Council of Great Lakes Governors, the states that border the Great Lakes (Illinois, Indiana, Michigan, Minnesota, New York, Ohio, Pennsylvania, and Wisconsin) developed a protocol for a Uniform Great Lakes Sport Fish Consumption Advisory (Anderson et al. 1993). That 1993 advisory protocol provides information on the health beneﬁts of ﬁsh; adverse effects of conta- minants; recommended quantity, frequency, and types of ﬁsh to consume; recommended ﬁshing locations; and preparation methods that can be used to reduce exposure to bioaccumu- lative contaminants such as PCBs and DDE (Anderson et al. 1993). In 1991 the Great Lakes Sport Fish Consortium of health departments in six of the eight GL states (Michigan and Pennsylvania were not members of the original consortium) was formed and received competitive funding from the Agency for Toxic Substances and Disease Registries. In 1993–1994 the consor- tium conducted a random-digit-dial telephone survey of 8,306 residents of the eight GL states to evaluate their total ﬁsh and GL sport-ﬁsh consumption habits, deﬁne at-risk subpopula- tions, and assess the effectiveness of state-issued consumption advisories. Households were selected by a computerized random-digit-dial system, and an adult was then randomly Address correspondence to P. Imm, Department of Health and Family Services, 1 West Wilson St., Room 150, Madison, WI 53703 USA. Telephone: (608) 267-3565. Fax: (608) 267-4853. E-mail: immpb@dhfs.state.wi.us This work was funded by U.S. Public Health Service Agency for Toxic Substances and Diseases Registry grant 75/ATH598322-03. The authors declare they have no competing ﬁnan- cial interests. Received 31 January 2005; accepted 13 June 2005. 1325