A community-based approach to disseminate health information on the hazards of prenatal mercury exposure in Brooklyn, NY

Abstract

Exposure to mercury (Hg) in utero can have neurotoxic effects on the developing fetus. Mercury exposure in women of childbearing age has been associated with frequent fish consumption, coastal proximity, foreign birth, and exposure during ritualistic practices. The aim of this study was to identify culturally-appropriate strategies to disseminate messages on the hazards of in utero Hg exposure in fertile and pregnant women in a predominantly urban immigrant community in Flatbush, Brooklyn, following findings from a recent study on mercury exposure in this community. Nineteen key informant interviews were conducted in Flatbush, Brooklyn with community members, medical professionals, fishmongers, and a religious practitioner to solicit feedback on culturally sensitive methods to educate the community on Hg hazards. The main themes identified include clinical integration, where providers integrate the message in routine care; community integration, whereby influential organizations and community members foster message delivery; media usage; and message reinforcement via continuous exposure. It is vital for healthcare providers and public health practitioners to be culturally sensitive in educating their patients on fish selection during pregnancy and safety of handling Hg. Instead of a single approach, a combination of media and educational strategies would help to reinforce the message. These findings form a basis for public health campaigns to apprise other urban immigrant communities of the hazards of in utero Hg exposure.

Factors Associated with High Mercury Levels in Women and Girls from The Mojana Region, Colombia, 2013–2015

“…This can have different effects depending on the dose. Findings have shown that children who are exposed prenatally to high levels of MeHg can be affected in various ways, including reduced brain size; cortical blindness; motor deficiencies; impaired auditory function, language development and memory; low IQ; impaired visual-spatial abilities; and mental retardation [8][9][10][11]. These effects may become evident over the medium-or long-term and are potentially irreversible [12].…”

Methylmercury Exposure in Women of Childbearing Age and Children

“…Although the goal of effective risk communication is to provide workers with necessary information to empower them to make healthy choices, the process essentially has two steps: (a) educating the educators (e.g., occupational health and environmental health nurses and other clinicians) and (b) educating women workers of childbearing age and working parents. Because the second step cannot be achieved without accomplishing the first step, it is essential that occupational health nurses are prepared to share accurate MeHg information with workers (e.g., Anderko, 2009; Callejo & Geer, 2012; Olson, 2013).…”

“…Environmental health nurses working with public health units are likely to develop and implement these programs. Callejo and Geer (2012) identified four ways through which communities can be made aware of in utero MeHg exposure: (a) clinical integration (e.g., providers communicate the message in routine care), (b) community integration (e.g., organizations promote the message to the public), (c) media coverage and dissemination, and (d) message persistence (e.g., continuous exposure via media outlets). Delivering the message involves the collaboration of many constituents within the community including health care providers, applicable government agencies, community leaders, and media outlets.…”

“…Delivering the message involves the collaboration of many constituents within the community including health care providers, applicable government agencies, community leaders, and media outlets. Examples of how community-based programs might be designed and implemented are reported by Callejo and Geer (2012) for Brooklyn, New York, and by Derrick, Miller, and Andrews (2008) for subsistence anglers in a Georgia community.…”

Doctors as disseminators? Practicing physicians as multipliers for community-based prevention networks in a large city in western Germany

“…Another example is found in the Dutch program "Healthy School Approach" (Pucher et al 2015), where physicians take on coordinating roles between the different sectors in public health services that have clear management structures. In regard to (2), a community-based program to prevent prenatal mercury poisoning was developed in a US study (Callejo and Geer 2012). In this case, physicians imparted specific health information to their patients during routine appointments.…”