Developing a Clinical Approach to Disseminating Fish Consumption Advisory Information

BACKGROUND:   Over the past several decades, state fish advisory programs have provided fish consumption advisory information directly to the public.  Although a variety of communication methods have been used, more work is needed as it can be difficult to translate public awareness into compliance through dietary behavior change to decrease exposure to contaminants through fish consumption.  Through a United States Environmental Protection Agency Great Lakes Restoration Initiative (GLRI) grant, the Wisconsin Department of Health Services implemented a web-based survey to Wisconsin anglers to better understand the reach of traditional fish consumption advisory messaging.  Responses from the 3,759 participants indicated that despite frequent fish consumption only 4% reported receiving dietary guidance from their health care provider and only 35% reported having seen the fish consumption advisory pamphlets.  These findings highlight the need to integrate fish consumption guidance into patient/ health-care provider encounters.

METHODS:   In 2014, in partnership with NorthLakes Community Clinic, DHS launched a clinical intervention project along the south shore of Lake Superior to assess fish consumption habits, advisory awareness, and mercury levels in hair among women of child bearing age.  Participants have been recruited through referrals from primary care providers, signage in clinics and letters to individual patients. Participants are existing patients of NorthLakes Community Clinic. Participation in this project involves two clinic visits to meet with project staff. A hair sample is collected at each visit and tested for mercury.  Project staff provide fish consumption advisory information to participants at the first visit and then, individual results-based education at the second visit, which occurs 6 months later.

RESULTS:   Results from this study will include the comparison of hair mercury results against participant responses to fish consumption questions to assess if responses alone can be an indicator of elevated mercury levels or not. Additionally, project staff will assess the effectiveness of their health education by comparing mercury levels in hair at each visit.

CONCLUSIONS:   This initiative aims to develop a sustainable, locally-based integrated approach to fish consumption advisories by utilizing biomonitoring to communicate fish consumption guidance.  Additionally, this project fills a documented gap in the existing guidance by targeting health care provides as a conduit for advisory information.