Use of Markov Chain Monte Carlo Analysis with a Physiologically-Based Pharmacokinetic Model of Methylmercury to Estimate Exposures in U.S. Women of Childbearing Age

A Bayesian approach, implemented using Markov Chain Monte Carlo (MCMC) analysis, was applied with a physiologically‐based pharmacokinetic (PBPK) model of methylmercury (MeHg) to evaluate the variability of MeHg exposure in women of childbearing age in the U.S. population. The analysis made use of the newly available National Health and Nutrition Survey (NHANES) blood and hair mercury concentration data for women of age 16–49 years (sample size, 1,582). Bayesian analysis was performed to estimate the population variability in MeHg exposure (daily ingestion rate) implied by the variation in blood and hair concentrations of mercury in the NHANES database. The measured variability in the NHANES blood and hair data represents the result of a process that includes interindividual variation in exposure to MeHg and interindividual variation in the pharmacokinetics (distribution, clearance) of MeHg. The PBPK model includes a number of pharmacokinetic parameters (e.g., tissue volumes, partition coefficients, rate constants for metabolism and elimination) that can vary from individual to individual within the subpopulation of interest. Using MCMC analysis, it was possible to combine prior distributions of the PBPK model parameters with the NHANES blood and hair data, as well as with kinetic data from controlled human exposures to MeHg, to derive posterior distributions that refine the estimates of both the population exposure distribution and the pharmacokinetic parameters. In general, based on the populations surveyed by NHANES, the results of the MCMC analysis indicate that a small fraction, less than 1%, of the U.S. population of women of childbearing age may have mercury exposures greater than the EPA RfD for MeHg of 0.1 μg/kgg/day, and that there are few, if any, exposures greater than the ATSDR MRL of 0.3 μgg/kgg/day. The analysis also indicates that typical exposures may be greater than previously estimated from food consumption surveys, but that the variability in exposure within the population of U.S. women of childbearing age may be less than previously assumed.     

An Exposure Assessment for Methylmercury from Seafood for Consumers in the United States

An exposure model was developed to relate seafood consumption to levels of methylmercury (reported as mercury) in blood and hair in the U.S. population, and two subpopulations defined as children aged 2-5 and women aged 18-45. Seafood consumption was initially modeled using short-term (three-day) U.S.-consumption surveys that recorded the amount of fish eaten per meal. Since longer exposure periods include more eaters with a lower daily mean intake, the consumption distribution was adjusted by broadening the distribution to include more eaters and reducing the distribution mean to keep total population intake constant. The estimate for the total number of eaters was based on long-term purchase diaries. Levels of mercury in canned tuna, swordfish, and shark were based on FDA survey data. The distribution of mercury levels in other species was based on reported mean levels, with the frequency of consumption of each species based on market share. The shape distribution for the given mean was based on the range of variation encountered among shark, tuna, and swordfish. These distributions were integrated with a simulation that estimated average daily intake over a 360-day period, with 10,000 simulated individuals and 1,000 uncertainty iterations. The results of this simulation were then used as an input to a second simulation that modeled levels of mercury in blood and hair. The relationship between dietary intake and blood mercury in a population was modeled from data obtained from a 90-day study with controlled seafood intake. The relationship between blood and hair mercury in a population was modeled from data obtained from several sources. The biomarker simulation employed 2,000 simulated individuals and 1,000 uncertainty iterations. These results were then compared to the recent National Health and Nutrition Examination Survey (NHANES) that tabulated blood and hair mercury levels in a cross-section of the U.S. population. The output of the model and NHANES results were similar for both children and adult women, with predicted mercury biomarker concentrations within a factor of two or less of NHANES biomarker results. However, the model tended to underpredict blood levels for women and overpredict blood and hair levels for children.     

Re-evaluation of the Reference Dose for Methylmercury and Assessment of Current Exposure Levels

Methylmercury (Me-Hg) is widely distributed through freshwater and saltwater food chains and human consumption of fish and shellfish has lead to widespread exposure. Both the U.S. EPA Reference Dose (0.3 μg/kg/day) and the FAO/WHO Permissible Tolerable Weekly Intake (3.3 μg/kg/week) are currently based on the prevention of paraesthesia in adult and older children. However, Me-Hg exposure in utero is known to result in a range of developmental neurologic effects including clinical CNS symptoms and delayed onset of walking. Based on a critical review of developmental toxicity data from human and animal studies, it is concluded that current guidelines for the prevention of paraesthesia are not adequate to address developmental effects. A dose of 0.07 μ/kg/day is suggested as the best estimate of a potential reference dose for developmental effects. Data on nationwide fish consumption rates and Me-Hg levels in fish/seafood weighted by proportion of the catch intended for human consumption are analyzed in a Monte Carlo simulation to derive a probability distribution of background Me-Hg exposure. While various uncertainties in the toxicologic and exposure data limit the precision with which health risk can be estimated, this analysis suggests that at current levels of Me-Hg exposure, a significant fraction of women of childbearing age have exposures above this suggested reference dose.     

Evaluation of the Uncertainty in an Oral Reference Dose for Methylmercury Due to Interindividual Variability in Pharmacokinetics

An analysis of the uncertainty in guidelines for the ingestion of methylmercury (MeHg) due to human pharmacokinetic variability was conducted using a physiologically based pharmacokinetic (PBPK) model that describes MeHg kinetics in the pregnant human and fetus. Two alternative derivations of an ingestion guideline for MeHg were considered: the U.S. Environmental Protection Agency reference dose (RfD) of 0.1 g/kg/day derived from studies of an Iraqi grain poisoning episode, and the Agency for Toxic Substances and Disease Registry chronic oral minimal risk level (MRL) of 0.5 g/kg/day based on studies of a fish-eating population in the Seychelles Islands. Calculation of an ingestion guideline for MeHg from either of these epidemiological studies requires calculation of a dose conversion factor (DCF) relating a hair mercury concentration to a chronic MeHg ingestion rate. To evaluate the uncertainty in this DCF across the population of U.S. women of child-bearing age, Monte Carlo analyses were performed in which distributions for each of the parameters in the PBPK model were randomly sampled 1000 times. The 1st and 5th percentiles of the resulting distribution of DCFs were a factor of 1.8 and 1.5 below the median, respectively. This estimate of variability is consistent with, but somewhat less than, previous analyses performed with empirical, one-compartment pharmacokinetic models. The use of a consistent factor in both guidelines of 1.5 for pharmacokinetic variability in the DCF, and keeping all other aspects of the derivations unchanged, would result in an RfD of 0.2 g/kg/day and an MRL of 0.3 g/kg/day.     

Human Mercury Toxicity and Ice Angler Fish Consumption: Are People Eating Enough to Cause Health Problems?

Mercury contamination of aquatic ecosystems is a global environmental concern. Bioaccumulation of mercury in fish exposes consumers to risk. We interviewed ice anglers on Monona Bay, Wisconsin during the 2001-2002 ice fishing season to determine risk associated with fish consumption and methyl mercury (MeHg) intake. The majority of anglers (95%) were not at risk of mercury toxicity because they ate less fish than would be required to create health problems. The remaining 5% of ice anglers barely exceeded the mercury toxicity threshold, with the exception of one angler who exceeded the threshold by 0.926 ppm. Anglers encountered were all male and predominantly Caucasian. Fish consumption by ice anglers was independent of awareness of consumption advisories, education, income, and age. This suggests that future awareness efforts should (1) identify groups of anglers most at risk and (2) create policies to effectively reach these audiences.     

Development of a Single-Meal Fish Consumption Advisory for Methyl Mercury

Methyl mercury (meHg) contamination of fish is the leading cause of fish consumption advisories in the United States. These advisories have focused upon repeated or chronic exposure, whereas risks during pregnancy may also exist from a single-meal exposure if the fish tissue concentration is high enough. In this study, acute exposure to meHg from a single fish meal was analyzed by using the one-compartment meHg biokinetic model to predict maternal hair concentrations. These concentrations were evaluated against the mercury hair concentration corresponding to the U.S. Environmental Protection Agency's reference dose (RfD), which is intended to protect against neurodevelopmental effects. The one-compartment model was validated against blood concentrations from three datasets in which human subjects ingested meHg in fish, either as a single meal or multiple meals. Model simulations of the single-meal scenario at different fish meHg concentrations found that concentrations of 2.0 ppm or higher can be associated with maternal hair concentrations elevated above the RfD level for days to weeks during gestation. A single-meal fish concentration cutoff of > or = 2.0 ppm is an important consideration, especially because this single high exposure event might be in addition to a baseline meHg body burden from other types of fish consumption. This type of single-meal advisory requires that fish sampling programs provide data for individual rather than composited fish, and take into account seasonal differences that may exist in fish concentrations.     

Combining Food Frequency and Survey Data to Quantify Long-Term Dietary Exposure: A Methyl Mercury Case Study

Twenty-four-hour recall data from the Continuing Survey of Food Intake by Individuals (CSFII) are frequently used to estimate dietary exposure for risk assessment. Food frequency questionnaires are traditional instruments of epidemiological research; however, their application in dietary exposure and risk assessment has been limited. This article presents a probabilistic method of bridging the National Health and Nutrition Examination Survey (NHANES) food frequency and the CSFII data to estimate longitudinal (usual) intake, using a case study of seafood mercury exposures for two population subgroups (females 16 to 49 years and children 1 to 5 years). Two hundred forty-nine CSFII food codes were mapped into 28 NHANES fish/shellfish categories. FDA and state/local seafood mercury data were used. A uniform distribution with minimum and maximum blood-diet ratios of 0.66 to 1.07 was assumed. A probabilistic assessment was conducted to estimate distributions of individual 30-day average daily fish/shellfish intakes, methyl mercury exposure, and blood levels. The upper percentile estimates of fish and shellfish intakes based on the 30-day daily averages were lower than those based on two- and three-day daily averages. These results support previous findings that distributions of "usual" intakes based on a small number of consumption days provide overestimates in the upper percentiles. About 10% of the females (16 to 49 years) and children (1 to 5 years) may be exposed to mercury levels above the EPA's RfD. The predicted 75th and 90th percentile blood mercury levels for the females in the 16-to-49-year group were similar to those reported by NHANES. The predicted 90th percentile blood mercury levels for children in the 1-to-5-year subgroup was similar to NHANES and the 75th percentile estimates were slightly above the NHANES.     

A Monte Carlo Risk Assessment Model for Acrylamide Formation in French Fries

The objective of this study is to estimate the likely human exposure to the group 2a carcinogen, acrylamide, from French fries by Irish consumers by developing a quantitative risk assessment model using Monte Carlo simulation techniques. Various stages in the French-fry-making process were modeled from initial potato harvest, storage, and processing procedures. The model was developed in Microsoft Excel with the @Risk add-on package. The model was run for 10,000 iterations using Latin hypercube sampling. The simulated mean acrylamide level in French fries was calculated to be 317 μg/kg. It was found that females are exposed to smaller levels of acrylamide than males (mean exposure of 0.20 μg/kg bw/day and 0.27 μg/kg bw/day, respectively). Although the carcinogenic potency of acrylamide is not well known, the simulated probability of exceeding the average chronic human dietary intake of 1 μg/kg bw/day (as suggested by WHO) was 0.054 and 0.029 for males and females, respectively. A sensitivity analysis highlighted the importance of the selection of appropriate cultivars with known low reducing sugar levels for French fry production. Strict control of cooking conditions (correlation coefficient of 0.42 and 0.35 for frying time and temperature, respectively) and blanching procedures (correlation coefficient −0.25) were also found to be important in ensuring minimal acrylamide formation.     

Ethnic Differences in Risk from Mercury among Savannah River Fishermen

Fishing plays an important role in people's lives and contaminant levels in fish are a public health concern. Many states have issued consumption advisories; South Carolina and Georgia have issued them for the Savannah River based on mercury and radionuclide levels. This study examined ethnic differences in risk from mercury exposure among people consuming fish from the Savannah River, based on site-specific consumption patterns and analysis of mercury in fish. Among fish, there were significant interspecies differences in mercury levels, and there were ethnic differences in consumption patterns. Two methods of examining risk are presented: (1) Hazard Index (HI), and (2) estimates of how much and how often people of different body mass can consume different species of fish. Blacks consumed more fish and had higher HIs than Whites. Even at the median consumption, the HI for Blacks exceeded 1.0 for bass and bowfin, and, at the 75th percentile of consumption, the HI exceeded 1.0 for almost all species. At the White male median consumption, noHI exceeded 1, but for the 95th percentile consumer, the HI exceeded 1.0 almost regardless of which species were eaten. Although females consumed about two thirds the quantity of males, HIs exceeded 1 for most Black females and for White females at or above the 75th percentile of consumption. Thus, close to half of the Black fishermen were eating enough Savannah River fish to exceed HI = 1. Caution must be used in evaluating an HI because the RfDs were developed to protect the most vulnerable individuals. The percentage of each fish species tested that exceeded the maximum permitted limits of mercury in fish was also examined. Over 80% of bowfin, 38% of bass, and 21% of pickerel sampled exceeded 0.5 ppm. The risk methodology is applicable anywhere that comparable data can be obtained. The risk estimates are representative for fishermen along the Savannah River, and are not necessarily for the general populations.     

Using Probabilistic Modeling to Evaluate Human Exposure to Organotin in Drinking Water Transported by Polyvinyl Chloride Pipe

The leaching of organotin (OT) heat stabilizers from polyvinyl chloride (PVC) pipes used in residential drinking water systems may affect the quality of drinking water. These OTs, principally mono- and di-substituted species of butyltins and methyltins, are a potential health concern because they belong to a broad class of compounds that may be immune, nervous, and reproductive system toxicants. In this article, we develop probability distributions of U.S. population exposures to mixtures of OTs encountered in drinking water transported by PVC pipes. We employed a family of mathematical models to estimate OT leaching rates from PVC pipe as a function of both surface area and time. We then integrated the distribution of estimated leaching rates into an exposure model that estimated the probability distribution of OT concentrations in tap waters and the resulting potential human OT exposures via tap water consumption. Our study results suggest that human OT exposures through tap water consumption are likely to be considerably lower than the World Health Organization (WHO) "safe" long-term concentration in drinking water (150 μg/L) for dibutyltin (DBT)—the most toxic of the OT considered in this article. The 90th percentile average daily dose (ADD) estimate of 0.034 ± 2.92 × 10⁻⁴μg/kg day is approximately 120 times lower than the WHO-based ADD for DBT (4.2 μg/kg day).     

Effects of Uncertainties on Exposure Estimates to Methylmercury: A Monte Carlo Analysis of Exposure Biomarkers versus Dietary Recall Estimation

This article presents a general model for estimating population heterogeneity and "lack of knowledge" uncertainty in methylmercury (MeHg) exposure assessments using two-dimensional Monte Carlo analysis. Using data from fish-consuming populations in Bangladesh, Brazil, Sweden, and the United Kingdom, predictive model estimates of dietary MeHg exposures were compared against those derived from biomarkers (i.e., [Hg]hair and [Hg]blood). By disaggregating parameter uncertainty into components (i.e., population heterogeneity, measurement error, recall error, and sampling error) estimates were obtained of the contribution of each component to the overall uncertainty. Steady-state diet:hair and diet:blood MeHg exposure ratios were estimated for each population and were used to develop distributions useful for conducting biomarker-based probabilistic assessments of MeHg exposure. The 5th and 95th percentile modeled MeHg exposure estimates around mean population exposure from each of the four study populations are presented to demonstrate lack of knowledge uncertainty about a best estimate for a true mean. Results from a U.K. study population showed that a predictive dietary model resulted in a 74% lower lack of knowledge uncertainty around a central mean estimate relative to a hair biomarker model, and also in a 31% lower lack of knowledge uncertainty around central mean estimate relative to a blood biomarker model. Similar results were obtained for the Brazil and Bangladesh populations. Such analyses, used here to evaluate alternative models of dietary MeHg exposure, can be used to refine exposure instruments, improve information used in site management and remediation decision making, and identify sources of uncertainty in risk estimates.     

Probabilistic Integrated Human Mixture Risk Assessment of Multiple Metals Through Seafood Consumption

Inorganic arsenic (iAs), cadmium (Cd), lead (Pb), and methylmercury (MeHg) are toxic metals that cause substantial health concern and are present in various seafood items. This study linked probabilistic risk assessment to the interactive hazard index (HI_INT) approach to assess the human mixture risk posed by the dietary intake of iAs, Cd, Pb, and MeHg from seafood for different age populations, and joint toxic actions and toxic interactions among metals were also considered in the assessment. We found that, in combination, an iAs–Cd–Pb–MeHg mixture synergistically causes neurological toxicity. Furthermore, an iAs–Cd–Pb mixture antagonistically causes renal and hematological effects and additively causes cardiovascular effect. Our results demonstrated that if toxic interactions are not considered, the health risk may be overestimated or underestimated. The 50th percentile HI_INT estimates in all age populations for neurological, renal, cardiovascular, and hematological effects were lower than 1; however, the 97.5th percentile HI_INT estimates might exceed 1. In particular, toddlers and preschoolers had the highest neurological risk, with 0.16 and 0.19 probabilities, respectively, of neurological HI_INT exceeding 1. Saltwater fish consumption was the principal contributor to the health risk. We suggest that regular monitoring of metal levels in seafood, more precise dietary surveys, further toxicological data, and risk–benefit analysis of seafood consumption are warranted to improve the accuracy of human mixture risk assessment and determine optimal consumption.     

Estimation of Dietary Exposure to Chemicals: A Case Study Illustrating Methods of Distributional Analyses for Food Consumption Data

There are a number of sources of variability in food consumption patterns and residue levels of a particular chemical (e.g., pesticide, food additive) in commodities that lead to an expected high level of variability in dietary exposures across a population. This paper focuses on examples of consumption pattern survey data for specific commodities, namely that for wine and grape juice, and demonstrates how such data might be analyzed in preparation for performing stochastic analyses of dietary exposure. Data from the NIAAA/NHIS wine consumption survey were subset for gender and age group and, with matched body weight data from the survey database, were used to define empirically-based percentile estimates for wine intake (μl wine/kg body weight) for the strata of interest. The data for these two subpopulations were analyzed to estimate 14-day consumption distributional statistics and distributions for only those days on which wine was consumed. Data subsets for all wine-consuming adults and wine-consuming females ages 18 through 45, were determined to fit a lognormal distribution ( R ²= 0.99 for both datasets). Market share data were incorporated into estimation of chronic exposures to hypothetical chemical residues in imported table wine. As a separate example, treatment of grape juice consumption data for females, ages 18–40, as a simple lognormal distribution resulted in a significant underestimation of intake, and thus exposure, because the actual distribution is a mixture (i.e., multiple subpopulations of grape juice consumers exist in the parent distribution). Thus, deriving dietary intake statistics from food consumption survey data requires careful analysis of the underlying empirical distributions.     

Estimates of per Capita Fish Consumption in the U.S. Based on the Continuing Survey of Food Intake by Individuals (CSFII)

This paper presents estimates of daily average per capita fish consumption by age and gender for the 48 conterminous states. The estimated consumption rates are reported for three fish habitats: freshwater/estuarine fish, marine fish, and all fish. The estimates were generated from the combined 1989, 1990, and 1991 Continuing Survey of Food Intake by Individuals (CSFII), a national food consumption survey conducted by the United States Department of Agriculture (USDA). Point and interval estimates of per capita fish consumption were generated from the empirical distribution of daily average per capita consumption. The point estimates include the mean, 50th, 75th, 90th, 95th, and 99th percentiles. Ninety percent confidence intervals are provided for the estimated mean and 90% bootstrap intervals are provided for percentile estimates. Information in a recipe file provided by USDA was used to calculate the amount of fish in recipes which contain fish. The estimated consumption rates are based on the weight of fish in its prepared or "as consumed" condition. The estimated mean consumption rate for all fish for the U.S. population of the 48 conterminous states was 15.65 grams/person/day (C.I.:14.67–16.63) of which 4.71 grams/person/day (C.I.:4.17–5.25) was freshwater/estuarine fish and 10.94 grams/person/day (C.I.: 10.14–11.73) was marine fish.     

A Comparative Pharmacokinetic Estimate of Mercury in U.S. Infants Following Yearly Exposures to Inactivated Influenza Vaccines Containing Thimerosal

The use of thimerosal preservative in childhood vaccines has been largely eliminated over the past decade in the United States because vaccines have been reformulated in single‐dose vials that do not require preservative. An exception is the inactivated influenza vaccines, which are formulated in both multidose vials requiring preservative and preservative‐free single‐dose vials. As part of an ongoing evaluation by USFDA of the safety of biologics throughout their lifecycle, the infant body burden of mercury following scheduled exposures to thimerosal preservative in inactivated influenza vaccines in the United States was estimated and compared to the infant body burden of mercury following daily exposures to dietary methylmercury at the reference dose established by the USEPA. Body burdens were estimated using kinetic parameters derived from experiments conducted in infant monkeys that were exposed episodically to thimerosal or MeHg at identical doses. We found that the body burden of mercury (AUC) in infants (including low birth weight) over the first 4.5 years of life following yearly exposures to thimerosal was two orders of magnitude lower than that estimated for exposures to the lowest regulatory threshold for MeHg over the same time period. In addition, peak body burdens of mercury following episodic exposures to thimerosal in this worst‐case analysis did not exceed the corresponding safe body burden of mercury from methylmercury at any time, even for low‐birth‐weight infants. Our pharmacokinetic analysis supports the acknowledged safety of thimerosal when used as a preservative at current levels in certain multidose infant vaccines in the United States.     

Perceptions of Recreational Fishing Boat Captains: Knowledge and Effects of Fish Consumption Advisories

The impacts of fish consumption advisories on recreational and subsistence fishing, particularly in fresh waters, have been examined extensively. By contrast, little attention has focused on organized recreational fishing, such as from party and charter boats, and particularly for salt water fish. We interviewed 93 New Jersey boat captains to determine their knowledge about fish consumption advisories, and whether, in their opinion, clients knew of fish consumption advisories, and whether they thought advisories had an effect on recreational fishing and their businesses. Advisories were ranked by captains as a moderate influence on the success of their business, less so than number of fish caught, strength of the economy, overfishing by commercial boats, and management regulations. Only one boat captain had not heard warnings about eating fish, but what captains said they had heard was mixed in its accuracy and completeness. Clients expect captains to know about fish, and about half of boat captains said clients had asked about the safety of eating fish. Captains who felt advisories were affecting their businesses tended to fish for species without high levels of mercury (except for bluefish) or PCBs, the primary contaminants of concern for state advisories and federal advice. However, these captains worked closer to areas (e.g., Raritan Bay complex and New York Harbor) subject to advisories than did other captains, and were more prone to say that management regulations (e.g., fish size, creel limits, seasons) and marketing and advertising by the industry or state were strong influences on the success of their seasons. Comparing captains who thought advisories had some or great effect (60%) versus those reporting "no effect" (40%), there was no difference in the mean percentage of trips targeting high mercury species such as swordfish and shark. Many captains said they would or might post advisories, but 42% of the boat captains said they would not post consumption warnings if the state provided them. The significant portion (at least 15%) of saltwater fishing supported by these businesses suggests that these captains are an important conduit for future risk communication.     

Determination of a Tolerable Daily Intake of DDT for Consumers of DDT Contaminated Fish from the Lower Yakima River, Washington*

DDT, DDE, and DDD have been detected at elevated concentrations in sediments and fish of the Yakima River, its tributaries and drainages. An assessment was conducted to evaluate the public health significance of eating fish from the river. This was accomplished by establishing a daily intake level of DDT for the population of greatest concern, and comparing this level to a tolerable daily intake. The most sensitive and highly exposed group was determined to be breastfeeding infants. Infant daily intakes of DDT, based on estimated mother's DDT-breast milk levels, were compared to a recommended tolerable daily intake. Results indicate that mothers who frequently consume Yakima River bottom-feeding fish could have breast milk DDT concentrations sufficiently high to expose their infants to levels above the tolerable daily intake.     

Assessing the Relationship Between Environmental Lead Concentrations and Adult Blood Lead Levels

This paper presents a model for predicting blood lead levels in adults who are exposed to elevated environmental levels of lead. The model assumes a baseline blood lead level based on average blood lead levels for adults described in two recent U.S. studies. The baseline blood lead level in adults arises primarily from exposure to lead in diet. Media-specific ingestion and absorption parameters are assessed for the adult population, and a biokinetic slope factor that relates uptake of lead into the body to blood lead levels is estimated. These parameters are applied to predict blood lead levels for adults exposed to a hypothetical site with elevated lead levels in soil, dust and air. Blood lead levels ranging from approximately 3-57 μg/dl are predicted, depending on the exposure scenarios and assumptions.     

Use of Quality-Adjusted Life Year Weights with Dose-Response Models for Public Health Decisions: A Case Study of the Risks and Benefits of Fish Consumption

Risks associated with toxicants in food are often controlled by exposure reduction. When exposure recommendations are developed for foods with both harmful and beneficial qualities, however, they must balance the associated risks and benefits to maximize public health. Although quantitative methods are commonly used to evaluate health risks, such methods have not been generally applied to evaluating the health benefits associated with environmental exposures. A quantitative method for risk-benefit analysis is presented that allows for consideration of diverse health endpoints that differ in their impact (i.e., duration and severity) using dose-response modeling weighted by quality-adjusted life years saved. To demonstrate the usefulness of this method, the risks and benefits of fish consumption are evaluated using a single health risk and health benefit endpoint. Benefits are defined as the decrease in myocardial infarction mortality resulting from fish consumption, and risks are defined as the increase in neurodevelopmental delay (i.e., talking) resulting from prenatal methylmercury exposure. Fish consumption rates are based on information from Washington State. Using the proposed framework, the net health impact of eating fish is estimated in either a whole population or a population consisting of women of childbearing age and their children. It is demonstrated that across a range of fish methylmercury concentrations (0-1 ppm) and intake levels (0-25 g/day), individuals would have to weight the neurodevelopmental effects 6 times more (in the whole population) or 250 times less (among women of child-bearing age and their children) than the myocardial infarction benefits in order to be ambivalent about whether or not to consume fish. These methods can be generalized to evaluate the merits of other public health and risk management programs that involve trade-offs between risks and benefits.     

Utilization survey of a rural creek fishery in central Alabama

A one-year angler intercept survey was conducted on Choccolocco Creek, a rural, limited access tributary to the Coosa River in northeastern Alabama. The purpose of the survey was to collect data and information about the behaviors and fish consumption habits of the recreational anglers who fish there. Nine survey locations were included in the stratified sampling plan, and sampling occurred throughout daylight hours, on weekdays and weekends/holidays, during all four seasons of the year. Surveys were completed on a total of 101 survey days between June 28, 2008 and June 27, 2009.(6) Seventy-two anglers were observed fishing during the survey period, and 52 (72%) of those individuals agreed to participate in the survey. Based on the information collected by the survey clerks, the angler population fishes the Creek between 1 and 54 times per year, with an average frequency of seven trips per year. The average number of months fished was three months per year, with a range of one to nine months. Only 15% of the anglers who participated in the survey (eight individuals) had succeeded in catching fish by the end of their trips, and only four of those individuals (8%) had retained any of the fish they had caught for consumption. Reasons provided for not retaining fish were that they either only fished for sport, did not catch enough fish to eat, or the fish they caught were too small to keep. Because so few anglers used and harvested fish from the resource, fish consumption rates could not be determined with a high degree of confidence. However, from these limited data it was estimated that the three anglers for whom consumption rates could be estimated had annualized average daily fish consumption rates of 0.14, 0.44, and 7.9 grams per day (g/day). The majority of anglers traveled less than 10 miles to fish the Creek. It was estimated that a total population of 173 anglers use the Creek each year. The results of this survey indicated that Choccolocco Creek is a local fishery that is not heavily used by area residents.