Abstract:
Fish consumption advisories are a form of intended risk reduction that aim to warn the public of possible dangers from consuming certain species of finfish and shellfish (herein referred to simply as 'fish'). While developing fetuses and children are particularly susceptible to toxicants in fish, fish also contain valuable nutrients such as Omega-3 fatty acids that promote neurodevelopment. Our hypothesis was that, viewed comprehensively across states, fish consumption advisories, which we recognize arise from a regulatory context driven by chemical contaminants, do not adequately address public health questions that sensitive populations face. In this analysis, we employed a comparative methodology to assess health messages contained in state advisory web sites that sensitive groups, including pregnant women and women of childbearing age, might access through the U.S. Environmental Projection Agency's National Listing of Fish Advisories Web site. We created over 50 criteria to evaluate advisory attributes, such as issuing agency, target audience, and risk and benefit clarity. We evaluated 48 state web sites containing fish consumption advice (Alaska and Wyoming have not issued advisories). The results of the comparative analysis represent a snapshot in time and thus reflect information available to sensitive populations searching the Internet for advice. Findings illuminate how little we know, or communicate, about health benefits conferred by specific nutrients in fish compared to health risks posed by chemical contaminants in fish. These results suggest that sensitive populations might not be receiving the tools and information they need to make healthy, informed eating decisions regarding fish consumption to optimize their health and the health of their offspring. Risk, but not benefit, messages targeting sensitive populations were more often clearly and sufficiently explained compared to messages targeting the general population, whereas documents, such as brochures, available on some advisory web sites specifically targeting sensitive populations conveyed both risk and benefit messages more consistently compared to advisory web sites overall.