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Chicago Tribune: Supermarkets throughout the Chicago area are routinely selling seafood highly contaminated with mercury, a toxic metal that can cause learning disabilities in children and neurological problems in adults, a Tribune investigation has found. (December 11, 2005) Response: This is a scientifically incomplete and inaccurate statement, invoking needless alarm leading to potentially health threatening nutritional decisions. Like almost any substance, including drinking water, mercury's potential for toxicity depends on dose -- how much one takes, over a time interval. Apart from the few well-reported acute direct mercury poisoning cases in the past – such as occurred in Minamata, Japan – there has been no convincing finding that regular consumption of fish with historically natural levels of mercury has caused "learning disabilities" in children. The best “evidence” presented for this claim is derived from a challenged study in the Faroe Islands, commonly used to suggest that prenatal exposure to micro-trace mercury might cause subtle deficits in neuropsychological performance. EPA’s Mercury Reference Dose (RfD)
Definition and description The U.S. Environmental Protection Agency's (EPA) dose level of concern is called a mercury reference dose (RfD). Understanding it is essential to sorting out the entire mercury debate and discussion which follows below. An RfD is an estimated (“with uncertainty spanning perhaps an order of magnitude”) amount of methylmercury one can consume every day, over a life time of 70 years without appreciable risk of deleterious effects. It is based on a worse case scenario of chronic, low level exposure that leads to a blood concentration of 58 parts per billion (ppb), and then divided by an extremely conservative factor of 10 as an "uncertainty" or safety cushion.  For context, EPA determined that its mercury reference dose should be set at 0.1 µg/kg/day. The FDA dose was established at 0.4, the Agency for Toxic Substances and Disease Registry (ATSDR) at 0.3, and the newly revised FAO/WHO level at 0.21. Viewed alternatively, EPA's mercury RfD “safe” dose is intake of 0.1 (µg/kg-day), reflected as 5.8 ppb (parts per billion) when measured in human blood, and about 1.0 ppm (parts per million) when measured in human hair. The estimation of a “safe” dose involves several judgments such as (a) the choice of the most appropriate No Observed Adverse Effect Level (NOAEL) or Benchmark Dose (BMD) of the critical effect, and (b) the choice of the appropriate uncertainty factors based on a review of the entire database. EPA’s rather extreme uncertainty factor of 10 exceeds those of other medical bodies and institutions. EPA's current mercury RfD seems arbitrarily the most restrictive in the world. (See also, Section 2) That is to say, EPA appears to have set the stage for alarm by (a) setting “low” estimates of safe levels, making things look worse than reality, and (b) setting “high” estimates of exposure, making things look worse than reality. The combination of the two can be highly deceptive. The alarm is compounded when concerned State officials, agitated by activists, decide to set even lower fish tissue concentration standards for triggering fish advisories. Perhaps, more appropriate would be establishing a realistic “safe” range instead of a single number beset with confusion and wide latitude for statistical mischief. The Problematic Faroe Islands Study Inappropriateness EPA’s mercury RfD is further problematic because it is based on inappropriate studies of people inhabiting the Faroese Islands who consume both fish (found to be generally low in mercury) and pilot whale meat and blubber (a unique practice no one in the US pursues) containing multiple, confounding chemicals (PCBs, cadmium, pesticides, persistent organic pollutants, DDT, etc.) of which mercury is only one. (And even here, the subtle effects ascribed to low MeHg doses do not constitute developmental disabilities as described by Dr. Myers above.) Adding to this chemical cocktail, a report recently released by the Danish government also found significantly high levels of perfluorooctane sulfonate (PFOS), perfluorooctane sulfonamide (PFOSA), polychlorinated naphthalenes (PCNs), and polybrominated diphenyl ethers (PBDEs) in pilot whales from the Faroe Islands. Regardless of the scientific debate (examined below) about whether the interpretation of the Faroese data constitutes sound or reliable evidence, it is clear that the study is simply inappropriate for EPA use in determining safe fish mercury exposure to Faroese children, let alone U.S. children. Dr. Pal Weihe, co-researcher of the Faroe study and Chief Physician of the department of occupational and public health for the Faroese hospital system implicitly agreed with this assessment in a letter to the Boston Herald dated February 9, 2004: In the Boston Herald, Friday, February 6, 2004, p. 20 the following was stated about a mercury study in the Faroe Islands conducted in cooperation with the Harvard University : “A fish industry spokesman said that the Harvard study was flawed because Faroe Islands women typically eat far more mercury-tainted fish than do Americans” This poses the question, how can EPA or the National Research Council (NRC) (see Sec. 7) seriously cling to the Faroe study as a basis for their RfD formulation when the lead author of the study states that it has nothing to do with MeHg in fish, but only in whale meat and blubber; and that both were highly contaminated with a mixture of known neurotoxins? There are additional serious issues of inappropriateness for the underlying epidemiological data from the Faroe Island children studies; not the least of which is the refusal of the Faroe Islands researchers and the Danish government to release their raw data for independent statistical analyses and verification. By continuing to rely on this black-boxed data, both EPA and the NRC violate EPA’s own data quality guidelines. The Boston Naming Test problems Nevertheless, CT and activists continue to rely heavily on the 2000 NRC Report, which concludes that the Boston Naming Test results of the Faroe Islands study are an appropriate basis for EPA’s mercury RfD. However, following a lengthy trial, a San Francisco Superior Court found in May 2006 that: “[T]he NRC failed to cite a critical paper in which the Faroe Islands authors state that a new cohort was being formed in the Faroe Islands to study the role of PCBs. Following the publication of the NRC report, four papers have been published discussing the high levels of PCBs in the Faroe Islands. Former EPA official and co-author of the mercury RfD, Dr. Deborah Rice, published a paper in 2003 in which she herself concluded that PCBs caused the reported performance deficiencies measured by the Boston Naming Test. However, according to the Judge’s findings, during the San Francisco trial, Rice inexplicably denied ever writing the paper. When shown the article in court, Dr. Rice then “admitted to reviewing and approving it, and that the article was published under her name.” Finally, the authors of the Faroe study themselves admitted to PCB confounding: Prenatal exposure to PCBs was examined by analysis of cord tissue from 435 children from a Faroese birth cohort... The association between cord PCB and cord-blood mercury (r=0.42) suggested possible confounding. While no PCB effects were apparent in children with low mercury exposure, PCB-associated deficits within the highest tertile of mercury exposure indicated a possible interaction between the two neurotoxicants. The limited PCB-related neurotoxicity in this cohort appears to be affected by concomitant methylmercury exposure. Considering the actual data itself, Fig. 1-A shows the rarely presented “smoking gun” evidence adopted by EPA and the NRC 2000 review to support claims of negative neuro-developmental impacts from prenatal exposure through marine consumption. The result was drawn from the Faroe Islands children study originally published by Grandjean et al. and the particular endpoint test is the so-called cued Boston Naming Test (not to be equated with IQ; an IQ test was never administered to the Faroe cohort).  Fig. 1-A clearly suggests a significant scatter in the test scores as the MeHg exposure level changes. In this curve fitting, there appears no strongly discernable trend even around 100 ppb, let alone at 5.8 ppb. In other words, EPA’s adopted MeHg RfD of 5.8 ppb shows a clear disconnect to the underlying data. Again, these data led Judge Robert Dondero to conclude after expert testimony that “The Boston Naming Test has no statistically significant relationship to methylmercury exposure.”It would be interesting to see a similar quantification of response functions to PCB exposure. It is worth repeating that this particular endpoint is among the best evidence relied upon by EPA and the NRC to suggest negative impacts with increasing MeHg exposure. (For more on the BNT, see Sec. 7) Figure 1-A contributes to the distinction between actual “potential levels of harm” or concern for MeHg in prenatal exposure and the hypothetical, ultra-precautionary level of safety set by EPA’s RfD. No equivalent epidemiological data has been produced demonstrating serious health concerns in adults from chronic exposure to methylmercury through dietary fish consumption. In fact, growing evidence exists for just the opposite (See Fish and Human Health below). Summary of Faroe Islands study problems • Unique dietary habits of consuming pilot whale meat and blubber, making the Faroese an inappropriate subject group for an American RfD. Again, it is critical to repeat that EPA defines its RfD for methylmercury as "an estimate (with uncertainty spanning perhaps an order of magnitude) of a daily exposure to the human population (including sensitive subgroups) that is likely to be without an appreciable risk of deleterious effects during a lifetime." Further, EPA didn’t account for the research showing fish are rich in selenium, which likely counteracts MeHg in fish. Pilot whales, on the other hand, are selenium deficient (see Sec. 11). Further clarification of EPA's RfD is discussed in Sec. 2 and 7. The Superior Seychelles Mercury Studies
An appropriate study In sharp contrast to the Faroe Island study, the Seychelles Child Development Study (SCDS) “was specifically designed to test the validity of [the] hypothesis [of adverse neurodevelopment effects] in a well-nourished population exposed to MeHg only from high consumption of unpolluted [other chemicals] ocean fish.” The Seychelles Island results are clearly superior for deriving RfD exposure to methylmercury for the U.S. population. This is so simply because that study is without toxic confounders and the Seychelles Island mothers consumed about 10 times the amount of fish as U.S. mothers - ocean fish containing MeHg concentrations comparable to those consumed by the general U.S. population, including Chicago area residents. This evaluation was confirmed in a post NRC (2000) analysis. Dourson et al. restated that “The Faroe Islands data are from exposures to a mixture of chemicals. The Seychelles Island data are from exposures to primarily one chemical, methyl Hg...We would...encourage EPA to use the Seychelles Island data as the basis of its methyl Hg RfD.” Dr. Dourson is the former EPA RfD/Reference Concentration Work Group co-chair. The SCDS authors from the University of Rochester recently concluded that: “[SCDS] longitudinal assessment at 9 years of age indicates no detectable adverse effects in a population consuming large quantities of a wide variety of ocean fish. These results are consistent with our earlier findings in the same children examined at 6, 19, 29 and 66 months of age. In Seychelles, fetal exposure was continuous through frequent consumption of ocean fish containing concentrations of MeHg comparable to those consumed by the general population in the USA. We recorded effects from covariates known to affect child development, but did not find an association with prenatal mercury.” (Emphasis added) Constantine Lyketsos of the John Hopkins Hospital offered a professional overview on the implications of the Seychelles study, concluding that: “On balance, the existing evidence suggests that methyl mercury exposure from fish consumption during pregnancy, of the level seen in most parts of the world, does not have measurable cognitive or behavioural effects in later childhood....If there is subtle association that could only have been detected in a much larger sample or through the use of more sensitive tests, it can reasonably be argued that the effect would be small enough to be essentially meaningless from the practical point of view. For now, there is no reason for pregnant women to reduce fish consumption below current levels, which are probably safe.” (Emphasis added) Highlights of Seychelles children study • Uncontaminated (by non-mercury compounds) ocean fish are sole source of exposure – no sea mammals in diet or fresh water fish in diets. Thus, at best, the Faroe Islands studies are useful for understanding a mixed chemical exposure, especially for PCB. The Seychelles Islands studies are very good at understanding exposures to primarily methyl mercury. In the interest of public health and wellbeing, EPA needs to reconsider - based on more recent science - and reset upwards its mercury RfD. The New Zealand Study
The first studies of prenatal low-level MeHg exposure were reported from New Zealand. There were two technical reports and one peer reviewed journal paper. The studies were discounted by most investigators, including EPA, until 1998 when the data were reanalyzed by Crump and published in a peer reviewed journal. The studies reported decreased performance on scholastic and psychological tests associated with high prenatal MeHg exposure. Results were included in a 2000 review conducted by the National Research Council (NRC) at the request of the EPA. Some researchers are cautious about relying on the NZ findings due to shortcomings: • Primary exposure through shark meat, some with up to 4 ppm of Hg. Iraqi Poisoned Grain-based RfD
In 1995, EPA established a consumption RfD based on an episodic MeHg exposure from the Iraqi seed grain poisoning incident in which people ate grain treated with a preservative of MeHg instead of planting it for crops. Later, realizing a lack of relevance of the Iraqi incident for mercury in fish, EPA shifted the basis of its RfD to the Faroe Islands study in 2001, urged on by the 2000 NRC report. Despite the drastic switch in the basis for the RfD derivation and with different rationale for the “less-than-default” uncertainty factor of 10, the new value of the RfD (5.8 ppb) suspiciously remained the same. In 2000, Crump noted that EPA’s early derivation of RfD from the Iraqi study was based on a Benchmark Dose Lower Limit (BMDL) value of 11 ppm in maternal hair. But a full assessment of the child data on age first walked, talked, and a neurological test by Crump et al. (1995) yielded BMDL values of 54 to 152 ppm, which is consistent with “other analysis of the Iraqi data that there was no conclusive evidence of a mercury effect below a maternal hair level of 80 ppm” (EPA’s current RfD is only about 1.0 ppm for hair). Miscellaneous Closer to home for the Chicago Tribune, a new study seeking to confirm potential health problems in children from consuming fish from the Canadian Great Lakes was simply "unsuccessful". Fish and Human Health
In sharp contrast to the Chicago Tribune’s lack of scientific evidence of harm from eating fish, beneficial effects of fish and fish oil consumption are well documented. Such health information is critical for making informed dietary decisions. The heartbreak of pre-term delivery Perhaps no one group is more at risk from mercury/fish alarmism than mothers. [for a more detailed discussion, see When Mercury Fears Harm at: http://ff.org/centers/csspp/pdf/szwarc_072006.pdf].  Claims of concern for fetal and child health by EPA, the CT and mercury activists largely fail to properly balance concerns and adequately inform women of the extraordinary benefits of fish nutrition during and after pregnancy.Premature birth is so serious an outcome for women that the March of Dimes organization has adopted it as a primary cause. More than 500,000 babies are born prematurely every year in the U.S. The infants aren’t just small; they’re developmentally “unfinished.” The March of Dimes provides these facts on prematurely born babies: • Pre-mature births have increased by 29 percent since 1981 (Fig. 1-B) Recognizing the critical role fish nutrition plays in helping prevent the tragedy of pre-term delivery, the March of Dimes is funding research. The research team of Olsen and Secher (2002) found that: “Low consumption of fish was a strong risk factor for preterm delivery and low birth weight. In women with zero or low intake of fish, small amounts of n-3 fatty acidsprovided as fish or fish oilmay confer protection against preterm delivery and low birth weight.” [Emphasis added] Olsen et al. suggested that higher fish intake by Faroe Island women compared with Danes was the reason for longer gestation in Faroese pregnancies. The researchers demonstrated that fish intake of 2.7g per day provided increases in gestation of 4 days for healthy women and 8.5 days for healthy women with a previous pre-term delivery. Further, Olsen and Secher found that women who consumed fish or seafood at least once a week during the first 16 weeks of pregnancy have one-third the normal risk of low-birth weight or premature births. Dr. Charles Lockwood, chairman of Obstetrics and Gynecology at the Yale School of Medicine observed: [T]here are lots of health benefits of eating fish and it is a relatively cheap source of protein. There may be additional benefits of reducing oxidative stresses that might induce pre-eclamsia or pre-term delivery; may affect fetal growth restriction by impairing placentation. So, there are lots of reasons to think that fish might be useful for pregnant women to take in… Postpartum depression and low seafood consumption Research by Dr. Joseph Hibbelin of the National institutes of Health calls attention to another serious risk for mothers associated with low intake of fish nutrition – postpartum depression. Available cross-national statistics strongly suggest a greater risk of postpartum depression with both low seafood consumption and low DHA content in the nursing mother’s milk (Fig. 1-C) Dr. Hibbelin reported that the “data suggest that the nearly 50-fold difference in prevalence rates of major postpartum depressive symptoms across countries is substantially associated with omega-3 fatty acid nutritional status.” 57  A further concern for postpartum depression is its sometime association with suicidal ideation. Improved fetal and child development A group of scientists from the National Institute of Environmental Health Sciences and the Institute of Child Health at the University of Bristol, UK reported important conclusions about the beneficial effects of marine fatty acids on the well being of young children: “Fish intake by the mother during pregnancy and by the infant postnatally, was associated with higher mean [child] development scores [in a cohort of 7421 British children]. For example, the adjusted mean MacArthur [vocabulary] comprehension score for children [15 months old] whose mothers consumed fish four or more times per week was 72 ... compared with [a score of] 68 among those whose mothers did not consume fish. ... Although the total cord mercury levels increased with maternal fish intake, our data did not suggest adverse developmental effects associated with mercury. In a small study of subjects in [this] ALSPAC [Avon Longitudinal Study of Parents and Children] study, maternal DHA levels were associated with improved visual stereoacuity among offspring at 3.5 years of age. ... Fish intake during pregnancy has the potential to improve fetal development because it is a good source of iron and long chain omega fatty acids, which are necessary for proper development and function of the nervous system.” [Emphasis added] The Tribune series also clearly missed the positive news for children with developmental coordination disorder (DCD) as reported in the May 2005 of the professional journal Pediatrics. Researchers found that: Mounting evidence suggests that a relative lack of certain polyunsaturated fatty acids may contribute to related neurodevelopmental and psychiatric disorders such as dyslexia and attention-deficit/hyperactivity disorder...Fatty acid supplementation may offer a safe efficacious treatment option for educational and behavioral problems among children with DCD. Breast Cancer Recent research suggests that high fish consumption is associated with low incidence of breast cancer. Coastal and rural-dwelling Japanese and Eskimos, who traditionally consume large quantities of fish, have low breast cancer rates. A study of Singapore Chinese women aged 45-74 suggested that an intake of approximately 40g of fish/shellfish per day can reduce breast cancer risk by 25%. Another study in Japan found that women who consumed about 5 servings of fish per week had a 10-20% lower risk than women consuming only 1 serving per week. A Norwegian study reported that women who consumed 5 servings of poached fish per month exhibited a 30% lower risk than did those who ate poached fish about 2 times per month. Kidney disorders A large, randomized and placebo-controlled trial reported that treatment for two years with a daily dose of EPA and DHA lowered the risk of death or end-stage renal disease by 67%. These benefits persisted after 6.4 years of follow-up. Stroke in men and women A large prospective study among 43,671 male health care professionals (aged 40-75 years) observed a 40% lower risk of ischemic stroke in those who consumed fish once per month or more compared to those who ate less often. Another prospective cohort study of 79,839 women aged 34-59 indicated that higher fish consumption is associated with a 48% reduced risk for thrombotic infarction among women who ate fish 2 to 4 times per week. Adult, type 2 diabetes Many observers see a modern epidemic of adult diabetes - diet and life-style induced. Diabetes affects an estimated 18,200,000 people and there are another 15,000,000 not yet diagnosed, just in the United States alone. Currently diabetes is the third leading cause of death in the United States. Common complications include eye damage and blindness; kidney failure; nerve damage to bladder, intestines, sexual organs, hands and feet; and heart problems. About 80% of type II diabetics die from heart disease. According to one report, the Pima Indians of the Southwestern United States had one case of diabetes in 1908. Today, 60% of all Pima adults suffer from type 2 diabetes. Dr. John Middaugh, State Epidemiologist of Alaska, reported to the FDA that many native Alaskan communities abandoned traditional fish diets since the FDA’s 2001 mercury advisory, with a subsequent increase in diabetes, heart disease and vitamin A and D deficiencies. A study by Salmeron et al. (2001) estimated that incidence of type 2 diabetes in women could be reduced about 40% by increased intake of omega-3 fatty acids (DHA + EPA) available in fish. And another study found that regular fish consumption led to a 64% reduction in the risk of heart disease in women with type 2 diabetes. Alzheimer Disease (AD) and adult cognitive abilities A large prospective study in a biracial Chicago community of 815 participants aged 65 to 94 years found that fish intake was associated with reduced risk of incident AD. Persons who consumed at least 1 fish meal per week had 60% less risk than persons who rarely ate fish. This study supports the protective associations found in two previous studies. Friedland et al. (2003) reports that Hendrie et al. found a low risk of AD from fish intake by Cree Indians in NE Canada. At the same time, Friedland and colleagues found a high prevalence of AD in the Arab population in Israel with a low rate of fish consumption. Kalmijn et al. reports that “the notion that dietary factors influence cognitive functions and subsequently the risk of dementia is growing.” Various studies have shown that even mild cognitive impairment progresses to dementia or AD at a rate of 10-15% per year. A study of 1613 men and women aged 45-70 years found fish consumption associated with better overall cognitive function and speed. Positive results were also recently reported from the Chicago Health and Aging Project at the Rush University Medical Center. In the December 2005 issue of the Archives of Neurology, Martha Morris and colleagues found that: Dietary intake of fish was inversely associated with cognitive decline over 6 years in this older, biracial community study [of 3718 adults 65 years and older at Chicago]. The rate of decline was reduced by 10% to 13% per year among persons who consumed 1 or more fish meals per week compared with those with less than weekly consumption. The rate of reduction is the equivalent of being 3 to 4 years younger in age. Other new results were reported by Weil et al. (2005) in the Journal of the American Medical Association. It was the first study attempting to assess the potential association of mercury exposure with adverse neurobehavioral outcomes for older adults in the general U.S. population. In this study, 474 participants were randomly selected from the larger pool of 1140 residents aged 50 to 70 years of the Baltimore Memory Study in order to confirm any potential associations of adverse neurobehavorial performance as functions of mercury levels measured in their blood. Weil et al. (2005) concluded that: “Overall, the data do not provide strong evidence that blood mercury levels are associated with worse neurobehavorial performance in [the] population of older urban adults [from their Baltimore Memory Study].” Finally, the abundance of Selenium (Se) found in fish seems to be a crucial nutrient for HIV-infected subjects. It is a potent inhibitor of HIV replication in vitro. Rayman reports that Se is a strong predictor of the outcome of HIV infection; that Se-deficient patients are 19.9 times more likely to die from HIV-related causes that those with adequate Se levels. The message from current research seems pole star clear that older Americans should eat lots of fish and not be dissuaded by mercury alarmists. Prostate cancer A recent study found that moderate or high fish intake could be associated with decreased risk of prostate cancer. The study examined a cohort of 6,272 Swedish men. These findings should be of particular concern to African-American males, who suffer a disproportional higher incidence of prostate cancer. Summary of health findings Clearly, the medical and nutritional literature on dietary fish consumption is rich with potential mitigations for a host of serious health concerns, especially those related to child birth and physiological and mental development of infants and young children. These include:  • Pre-term delivery and low birth weights, and physiological and mental development of infants and young children Dietary benefits These scientific health findings -- ignored by CT -- support the general conclusion of the 2005 Dietary Guideline for Americans: For most people, the risk from mercury by eating fish and shellfish is not a health concern.  The scientific results also clearly support the latest recommendation on fish consumption by National Oceanic and Atmospheric Administration Fisheries group (emphasis added): “Backed by compelling science that links seafood consumption to reduced risk of disease, the U.S. government this week is recommending that all Americans - especially pregnant & nursing women and children - eat two seafood meals per week that are rich in omega-3 fatty acids. This recommendation is included in USDA's 2005 dietary guidelines and is being reiterated by the National Oceanic and Atmospheric Administration. ... By eating the right kinds of seafood, pregnant and nursing women pass to their baby important nutrients that aid in brain development and may lessen the effects of dyslexia, autism, hyperactivity and attention deficit disorder, according to scientists presenting at the conference. [Note this international conference was sponsored by the governments of the United States, Canada, Iceland and Norway with technical assistance from the Food and Agriculture Organization of the United Nations.] Studies also have presented a link between these nutrients and increased intelligence in infants and young children. Species that are rich in these nutrients - omega-3 fatty acids, iodine, iron and choline - include wild and farmed salmon, cod, shrimp and canned light tuna. Salmon appears to be the king of fish, especially for pregnant and nursing women; it is exceptionally low in mercury and exceptionally high in omega-3 and selenium (see Sec. 11). Women will not put their babies at risk – even under EPA’s extreme RfD – if they avoid eating shark, swordfish, tilefish, king mackerel, tuna steaks and whale meat until after they have delivered and stopped breast feeding, scientists said. Exposure to mercury found in those species during the sensitive stages of fetal brain development may cause neurological damage. As an extra precaution, women who plan to become pregnant should avoid those species for six months before conception. These are conservative guidelines, considering the 10-fold safety margin built in for precaution, and the fact that mercury is eliminated from the body in about 60 days. Scientists reiterated that there is no evidence of health risk to the rest of the population, including children and the elderly, from eating seafood. To the contrary, studies have shown seafood consumption to help people live longer, healthier lives. Seafood cuts the risk for heart disease, cancer, Alzheimer's, stroke, diabetes, and inflammatory diseases such as rheumatoid arthritis. Further, studies show that nutrients found in whole fish and shellfish – not fish oil supplements – help the body heal after cancer treatments, and ward off auto-immune conditions, allergies, asthma, migraines, skin conditions, and Crohn's disease. Studies have found that people with omega-3 fatty acid deficiencies are also at greater risk for sleep problems, depression, stress, schizophrenia and aggressive behavior. Conclusion Any calls for reductions in fish consumption, inherent in ill-informed fish advisories or unbalanced alarmist claims by activists and the press, must take extreme precaution against promoting widespread public health threats. The most fundamental principle must be to do no harm in the first place. The CT series does not measure up. It has clearly failed to report from a vast, current literature that there are far greater, real risks from restricting or avoiding fish, and that the supposed evidence for "learning disabilities in children and neurological problems in adults" from eating fish is weak or simply does not exist. By this, CT is doing great harm. |
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