National Public Health Institute, Finland Balancing between benefits and risks. Baltic fish species...
-
Upload
dorothy-johnson -
Category
Documents
-
view
213 -
download
0
Transcript of National Public Health Institute, Finland Balancing between benefits and risks. Baltic fish species...
National Public Health Institute, Finlandww
w.kt
l.fi
Balancing between benefits and risks. Baltic fish species as a food
resource
Jouni TuomistoNational Public Health Institute (KTL)
Kuopio, Finland
National Public Health Institute, Finlandww
w.kt
l.fi
Critical questions about benefits and risks of fish
• Fish is healthy, but how healthy is it actually?• What are the major health risks related to fish?• What are the specific issues in the Baltic region?• Should there be specific recommendations due to
health impacts?• How is health related to marine sustainability?
National Public Health Institute, Finlandww
w.kt
l.fi
Mozaffarian & Rimm, JAMA. 2006;296:1885-1899
National Public Health Institute, Finlandww
w.kt
l.fi
Mozaffarian & Rimm, JAMA. 2006;296:1885-1899
National Public Health Institute, Finlandww
w.kt
l.fi
Hites (2004): Farmed salmon is more polluted
Hites et al., Science 2004
National Public Health Institute, Finlandww
w.kt
l.fi
National Public Health Institute, Finlandww
w.kt
l.fi
Dioxin concentrations in farmed and wild salmon
0 2 4 6 8 10 12 14 16 18 20
Wild chum, Kodiak AK (lowest wild)
Wild chinook, British Columbia (highest wild)
Farmed rainbow trout, Finland
Farmed salmon, Chile (lowest farmed)
Farmed salmon, Frankfurt (highest supermarket)
Farmed salmon, Scotland (highest farmed)
Wild salmon, Southern Baltic Sea
Wild salmon, Gulf of Finland
Wild salmon, Gulf of Bothnia
TEQ (ng/kg in fat)
National Public Health Institute, Finlandww
w.kt
l.fi
Farmed salmon: Two different decisions
Pollutanthealth risk
Health effectof fish
Net healtheffect
Pollutantexposure
Fish feedLower limitsfor pollutantsin fish feed?
Exposure-response
function foromega3
Exposure-response
function forpollutant
risk
Food intake
Recommend restrictedfarmed salmonconsumption?
Omega3content in
salmon
Omega3exposure
Pollutants insalmon
National Public Health Institute, Finlandww
w.kt
l.fi
What is the right health metric?
BAU
Restrict fish use
30900
23400
-206
-154
If risk managers assume responsibility of total health effect of salmon consumption
If risk managers care only for cancer due to pollutants
30000250000
BAU
Restrict fish use
30900
23400
-206
-154
If risk managers assume responsibility of total health effect of salmon consumption
If risk managers care only for cancer due to pollutants
30000250000
National Public Health Institute, Finlandww
w.kt
l.fi
Table 3: Annual health loss (in DALYs) due to dietary factors and energy balance, against other lifestyle factors, environmental factors and disease categories in the Netherlands. (Source: RIVM 2004)
DALYs lost
DIET OTHER DISEASES
Dietary factors Microbiological contamination Chemical contamination
Other lifestyle factors Environmental factors
Selection from Puclic Health Status Forecasts report 2002
>300 000 Unhealthy diet total (1) Three lifestyle factors combined (2), smoking
Cardiovascular diseases, all cancers
100 000- 300 000
5 dietary factors together, energy balance (3)
Lack of physical activity Coronary disease, depression, lung cancer, diabetes, alcohol-dependency
30 000- 100 000
Too much trans fatty acids, too little fruit, vegetables and fish
Alcohol consumption (4) Road traffic accidents, breast cancer
10 000- 30 000
Too much saturated fatty acids Particulate matter in atmosphere
Schizophrenia, prostate cancer, influenza
3000- 10 000
Gastroenteritiscaused by microorganisms in food
Passive smoking Upper respiratory tract infections, HIV/AIDS, stomach/intestinal ulcers
1000-3000 Radon (interior) Bacterial meningitis, bacterial STDs (5), tuberculosis
300-1000 Campylobacter in food Allergens, acrylamide
<300 STEC 0157 (5) PAHs (5), other substances
Various substances
National Public Health Institute, Finlandww
w.kt
l.fi
'Evidence lost'Dariush Mozaffarian, lead author of the study said:
"Overall, for major health outcomes among adults, the benefits of eating fish greatly outweigh the risks.
"Somehow this evidence has been lost on the public." Source: BBC News, 17.10.2006By the author of a large fish health review (Mozaffarian
& Rimm, JAMA. 2006;296:1885-1899)
National Public Health Institute, Finlandww
w.kt
l.fi
Benefits and risks of eating Baltic fish• Health benefits of eating fish are clear• The average population should eat more fish, at
least twice a week• A variety of fish species should be used• Even if the Baltic Sea is polluted with dioxins and
PCBs, the health benefits are 10-100 times higher than risks
• Special groups should be aware of certain risks (pregnant and nursing women, high (local) methyl mercury levels in some species)
National Public Health Institute, Finlandww
w.kt
l.fi
Health, fish, and sustainability• Fisheries are deteriorating due to overharvesting
(Worm et al: Impacts of Biodiversity Loss on Ocean Ecosystem Services. Science Nov 3 2006: 787-790)
Why don't we simply use farmed fish?– Fish eat fish: farming is only improvement of marine
resources for human use• Lack of suitable terrestrial fish feed sources• If feed is low with omega-3, also the fish will be
• Marine food resources are NOT easily replacedThe sustainability of seas is also an important
health issue
National Public Health Institute, Finlandww
w.kt
l.fi
National Public Health Institute, Finlandww
w.kt
l.fi
Table 3: Annual health loss (in DALYs) due to dietary factors and energy balance, against other lifestyle factors, environmental factors and disease categories in the Netherlands.
DALYs lost
DIET OTHER DISEASES
Dietary factors Microbiol. contaminat.
Chemical contamination
Other lifestyle factors
Environmental factors Selection from Puclic Health Status Forecasts report 2002
>300 000 Unhealthy diet total (1)
Three lifestyle factors combined (2), smoking
Cardiovascular diseases, all cancers
100 000-300 000
5 dietary factors together, energy balance (3)
Lack of physical activity
Coronary disease, depression, lung cancer, diabetes, alcohol-dependency
30 000-100 000
Too much trans fatty acids, too little fruit, vegetables and fish
Alcohol consumption (4)
Road traffic accidents, breast cancer
10 000- 30 000
Too much saturated fatty acids
Particulate matter in atmosphere
Schizophrenia, prostate cancer, influenza
3000- 10 000
Gastroenteritiscaused by microorganisms in food
Passive smoking Upper respiratory tract infections, HIV/AIDS (5), stomach/intestinal ulcers
1000-3000 Radon (interior) Bacterial meningitis, bacterial STDs (5), tuberculosis
300-1000 Campylobacter in food
Allergens, acrylamide
<300 STEC 0157 (5) PAHs (5), other substances Various substances
National Public Health Institute, Finlandww
w.kt
l.fi
Value of information for feed contaminant restrictions
Tuomisto et al., Science 2004
National Public Health Institute, Finlandww
w.kt
l.fi
Kalalaji
Keskimääräinen kulutus
Suomessa (g/viikko)
Pitkäaikaisesti voi syödä ilman
huolta ympäristömyrkyistä (g/viikko)+
Monikokertaiset terveyshyödyt
ympäristömyrkkyjen haittoihin
verrattuna vähintään
Oleellinen ympäristömyrk
ky
Kasvatettu kirjolohi 25 500 600 Dioksiini
Silakka 20 40-400 20 Dioksiini, Riippuu
silakan koosta,
Hauki 14 140 5-50 Elohopea sisävesillä
Ahven 10 300 10-100 Elohopea sisävesillä
Muikku 10 400 50-500 Elohopea sisävesillä
Siika 8 300 100 Dioksiini merialueella
Kuha 9 900 10-100 Elohopea sisävesillä
Villilohi (Itämeri ja joet)
5 50 60 Dioksiini
Kampela 0,4 200 60 Dioksiini merialueilla
Made 1 200 5-50 Elohopea sisävesillä