Fishing is a beloved pastime, and a source of affordable, local food for many North Carolinians. However, eating fish from North Carolina waterways can also pose health risks. Industrial chemical contaminants, including mercury and polychlorinated biphenyls (PCBs), can accumulate in fish and threaten the health of the public. Fish consumption advisories (FCAs) typically identify how much of a specific fish species can be safely consumed, unless a given species of fish is too contaminated to be eaten at all. Advisories tend to be more restrictive, or even prohibitive, for populations that are most vulnerable to the potential health effects of environmental contaminants, such as children and women of child-bearing age.
Researchers from the University of North Carolina at Chapel Hill (UNC), North Carolina State University (NCSU), and Duke University have been working with key stakeholders in the FCA process for the last decade to better understand perceptions of FCAs and, ultimately, to protect public health. In March 2019, an organizing committee with representatives from the UNC Center for Environmental Health and Susceptibility, NCSU Center for Human Health and the Environment, and the Duke Superfund Research Center sought out participation from diverse stakeholders for another forum. The 2019 NC Fish Forum was held to explore innovative approaches by local governments with the goals to: increase understanding of the FCA process, foster greater collaboration among stakeholders, and identify opportunities to improve existing processes.
Vision for the Future
Our ultimate vision is that fewer people—particularly those who are most vulnerable to harm, such as children and pregnant women—eat unhealthy amounts of contaminated fish. The following foundational elements of this vision increase the likelihood that we achieve it.
- FCA procedures (e.g. which fish to collect, sampling and analysis costs, risk assessment process) should be clearly communicated and widely available.
- State agencies, universities, and other stakeholders should engage and consult with local governments early and throughout the process of establishing FCAs.
- FCA outreach efforts should specifically involve and target vulnerable populations.
- Public perception pf FCAs and lack of compliance are persistent obstacles for effective fish consumption advisories.
- Promoting public understanding of FCAs is also challenging due to the narrow focus of some advisories on specific water bodies or fish species.
- Improving communication between FCA stakeholders allows for faster progress to promote public health, but also highlights tensions between messaging to encourage fishing and fish consumption, and messages that warn of potential health risks.
To overcome those challenges and create more effective advisories, 2019 NC Fish Forum participants came to the following conclusions:
- There is a need to address the constraints of limited resources to support effective FCA development and communication, and increase collaboration across participating agencies.
- FCAs can be an impactful health promotion tool, but that requires active engagement with all key stakeholders, especially local government agencies. Academic partners can help local agencies by developing templates and other resources for impactful communication of FCAs (see figure below).
- All participants in the FCA process should clearly understand the process and their roles, and be provided with resources and tools to successfully fulfill those roles.