141st APHA Annual Meeting

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Something fishy: Fish advisory considerations for public health nurses

Tuesday, November 5, 2013 : 11:10 AM - 11:30 AM

Ann Backus, MS , Harvard School of Public Health, Room 1-1402, Harvard-NIEHS Center for Environmental Health, Boston, MA
Jeanne B. Hewitt, PhD RN , NIEHS-funded Children's Environmental Health Sciences Core Center P30 ES004184, University of Wisconsin-Milwaukee, Milwaukee, WI
Background and Issues: Both federal and state health agencies issue fish advisories for the general population and/or vulnerable groups Advisories can be confusing because recommendations differ based on fish species, and contaminant levels vary depending on size of fish, species, location and type of water bodies. Consumption assumptions such as portion size and background exposure are not consistent across advisories. Description: Using a broad group of scientists including developmental toxicologists and epidemiologists, environmental public health leaders, public health nurses, risk analysts, and community members who are subsistence fishers and/or community leaders, we have constructed a case-study that helps public health and primary care providers (nursing and medicine) understand the benefit tradeoffs and ways to minimize risks and maximize the benefits of eating locally caught or purchased fish. A source of high quality, low fat protein and of essential omega 3-fatty acids, fish is free or nearly to subsistence and sport fishers. The case is well-grounded in the science of methylmercury and fat-soluble environmental chemicals (polychlorinated biphenyls [PCBs] and dioxins) and uses scenarios from ethnic communities to illustrate the application of fundamental concepts to practice. Revisions followed pre- and post-beta testing. Lessons Learned: Practitioners are able to provide accurate instruction to their patients and the public regarding the benefits of eating fish and reducing the risk of consuming neurotoxic and endocrine disrupting contaminants. Recommendations: This case study helps educate public health and private practitioners about the benefits and risks of eating fish and clears-up some of the confusion accompanying fish advisories.

Learning Areas:
Basic medical science applied in public health
Environmental health sciences
Public health or related education
Public health or related laws, regulations, standards, or guidelines
Public health or related nursing
Public health or related public policy

Learning Objectives:
Explain what contributes to confusion in and between fish advisories. Use examples from the case study to describe how research has contributed to our knowledge of the benefits and risks of fish consumption. Construct a basic and clear message for a vulnerable population about the benefits and risks of eating local fish.

Keywords: Community Health, Nursing Education

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Ann Backus, MS, has expertise in this area based on participating in a four-year collaborative study on mercury contamination of fish in the Grand Lake watershed in northeastern Oklahoma, and in the construction of local fish advisories based on study results and suggestions from community-based focus groups. She collaborated materially with Dr. Jeanne Hewitt on two other case studies for public health nursing education on Lyme Disease and Arsenic.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.