Health effects of nutrients and environmental pollutants in Baltic herring and salmon: a quantitative benefit-risk assessment

Abstract

Background: Health risks linked with dioxin in fish remain a complex policy issue. Fatty Baltic fish contain persistent pollutants, but they are otherwise healthy food. We studied the health benefits and risks associated with Baltic herring and salmon in four countries to identify critical uncertainties and to facilitate an evidence-based discussion. Methods: We performed an online survey investigating consumers' fish consumption and its motivation in Denmark, Estonia, Finland, and Sweden. Dioxin and methylmercury concentrations were estimated based on Finnish studies. Exposure-response functions for several health endpoints were evaluated and quantified based on the scientific literature. We also quantified the infertility risk of men based on a recent European risk assessment estimating childhood dioxin exposure and its effect on sperm concentration later in life. Results: Baltic herring and salmon contain omega-3 fatty acids and vitamin D, and the beneficial impact of these fishes on cardiovascular diseases, mortality, and the risk of depression and cancer clearly outweighs risks of dioxins and methylmercury in people older than 45 years of age and in young men. Young women may expose their children to pollutants during pregnancy and breast feeding. This study suggests that even in this critical subgroup, the risks are small and the health benefits are greater than or at least similar to the health risks. Value of information analysis demonstrated that the remaining scientific uncertainties are not large. In contrast, there are several critical uncertainties that are inherently value judgements, such as whether exceeding the tolerable weekly intake is an adverse outcome as such; and whether or not subgroup-specific restrictions are problematic. Conclusions: The potential health risks attributable to dioxins in Baltic fish have more than halved in the past 10 years. The new risk assessment issued by the European Food Safety Authority clearly increases the fraction of the population exceeding the tolerable dioxin intake, but nonetheless, quantitative estimates of net health impacts change only marginally. Increased use of small herring (which have less pollutants) is a no-regret option. A more relevant value-based policy discussion rather than research is needed to clarify official recommendations related to dioxins in fish.

<p>Food Pyramid for Subjects with Chronic Obstructive Pulmonary Diseases</p>

“…The risks regarding dioxin and polychlorinated biphenyls (PCB) intake are small and the health benefits are greater than, or at least similar to, the health risks, as recently demonstrated in a study that evaluated quantitative benefit-risk assessment. 59…”

From insight network to open policy practice: practical experiences

“…Causal modelling and causal graphs, as such, are old ideas, and there are various methods developed for Fig. 3 Insight network about dioxins, Baltic fish and health as described in the BONUS GOHERR project [31]. Decisions are shown as red rectangles, decision-makers and stakeholders as yellow hexagons, decision objectives as yellow diamonds, and substantive issues as blue nodes.…”

“…3 In the early cases, the main purpose was to give structure to discussion about and examination of an issue rather than to be a backbone for quantitative models. In later implementations, such as in the composite traffic assessment [34] or BONUS GOHERR project [31], diagrams have been used for both purposes. Most open assessments discussed later (and listed in Additional file 1: Appendix S1) have used insight networks to structure and illustrate their content.…”

“…This is a major challenge, because political processes may proceed rapidly and change focus, and quantitative assessments take time. A positive example of agility was a dioxin assessment model that had been developed in several projects during a few years (assessment 16 in Table S1-1) [31]. When the European Food Safety Authority released their new estimates about dioxin impacts on sperm concentration [43], the assessment model was updated and new sperm concentration results were produced within days.…”

Evidence on the impact of Baltic Sea ecosystems on human health and well-being: a systematic map

“…For example, regulations to reduce coastal disturbances and harmful activities in the sea area are a prerequisite for the sustainable management of fish stocks [ 5 , 14 ]. In addition, efforts to reduce long-term pollutants have repercussions in reducing potential carcinogens in seafood (for example [ 5 , 15 , 16 ]). These policies, however, need to be based on sound scientific evidence.…”