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Alison C. Scherer,^1,2 Ami Tsuchiya,^1,2 Lisa R. Younglove,^1,2 Thomas M. Burbacher,^1,3 and Elaine M. Faustman^1,2

¹Department of Environmental and Occupational Health Sciences, School of Public Health and Community Medicine, University of Washington, Seattle, Washington, USA; ²Institute for Risk Analysis and Risk Communication, University of Washington, Seattle, Washington; ³Center for Ecogenetics and Environmental Health, University of Washington, Seattle, Washington

Abstract
Objective: Fish consumption advisories are issued to warn the public of possible toxicological threats from consuming certain fish species. Although developing fetuses and children are particularly susceptible to toxicants in fish, fish also contain valuable nutrients. Hence, formulating advice for sensitive populations poses challenges. We conducted a comparative analysis of advisory Web sites issued by states to assess health messages that sensitive populations might access.

Data sources: We evaluated state advisories accessed via the National Listing of Fish Advisories issued by the U.S. Environmental Protection Agency.

Data extraction: We created criteria to evaluate advisory attributes such as risk and benefit message clarity.

Data synthesis: All 48 state advisories issued at the time of this analysis targeted children, 90% (43) targeted pregnant women, and 58% (28) targeted women of childbearing age. Only six advisories addressed single contaminants, while the remainder based advice on 2–12 contaminants. Results revealed that advisories associated a dozen contaminants with specific adverse health effects. Beneficial health effects of any kind were specifically associated only with omega-3 fatty acids found in fish.

Conclusions: These findings highlight the complexity of assessing and communicating information about multiple contaminant exposure from fish consumption. Communication regarding potential health benefits conferred by specific fish nutrients was minimal and focused primarily on omega-3 fatty acids. This overview suggests some lessons learned and highlights a lack of both clarity and consistency in providing the breadth of information that sensitive populations such as pregnant women need to make public health decisions about fish consumption during pregnancy.

Key words: advisory/advisories, benefits, consumption, contaminants, fish, nutrition/nutritional, pregnant women, risks, sensitive populations, women of childbearing age. Environ Health Perspect 116:1598–1606 (2008) .  doi:10.1289/ehp.11372 available via http://dx.doi.org/ [Online 1 August 2008]

Address correspondence to E.M. Faustman, Institute for Risk Analysis and Risk Communication, 4225 Roosevelt Way NE #100, Seattle, WA 98105 USA. Telephone (206) 685-2269. Fax: (206) 616-4875. E-mail: faustman@u.washington.edu

This work was supported by the Pacific Northwest Center for Human Health and Ocean Studies [National Institute of Environmental Health Sciences/National Institutes of Health (NIEHS/NIH) grant P50 ES012762 and National Science Foundation (NSF grant OCE-0434087) ]. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of NIEHS, NIH, or NSF.

The authors declare they have no competing financial interests.

Received 14 February 2008 ; accepted 1 August 2008.