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Publications
Letter to the Health Care Professionals (1998)
United States Government
Agency for Toxic Substance and Disease Registry
December 1998
Dear Health Care Professional:
Exposure to chemical contaminants through consumption of contaminated fish is a public health concern. We are writing to you to emphasize the need for health care professionals and providers to be aware of, and to ensure the public is aware of, the health consequences that can result in those populations who consume noncommercial fish (i.e., fish caught through sport or subsistence fishing). We are especially concerned about the more susceptible populations including, sport anglers, the elderly, children, pregnant women, and nursing infants.
In February 1998, the Administration published the Clean Water Action Plan: Restoring and Protecting America's Water. This Plan provides a blueprint for a new cooperative approach to identify and solve pollution problems and to inform citizens and officials about the quality of water and the safety of the fish and drinking water that come from them, as well as the beaches that surround them. The premise of the Action Plan is to ensure that citizens and officials can make informed and better decisions with clear, accurate, and timely information.
The enclosed technical paper, Public Health Implications of Polychlorinated Biphenyls (PCBs) Exposures, was developed by the Agency for Toxic Substances and Disease Registry (ATSDR) and the U.S. Environmental Protection Agency (EPA) and is part of the Clean Water Action Plan. Human health studies discussed in this paper indicate that exposure to PCBs (1) may disrupt a woman's reproductive function; (2) causes neurobehavioral and development deficits to occur in newborns and continue through school-aged children from in utero exposure; (3) is associated with other systemic effects (e.g., liver disease and diabetes, compromised immune function, and thyroid effects); and (4) increases cancer risks. For more information regarding PCBs and levels of concern in fish and wildlife tissue we recommend you consult ATSDR's Toxicological Profile for Polychlorinated Biphenyls and EPA's documents titled Guidance For Assessing Chemical Contaminant Data For Use in Fish Advisories, Volume I: Fish Sampling and Analysis (EPA-823-R-95-007) and Volume II: Risk Assessment and Fish Consumption Limits (EPA-823-B-97-009).
By 1997, fish advisories had been issued for more than 16% of the lake acres and more than 6% of river miles in the United States. Over the last 5 years, advisories issued in this country have increased more than 80%. These increases have occurred mostly as a result of increased monitoring and awareness by governmental agencies of the potential health risks associated with noncommercial, contaminated fish.
Recent studies complement and continue to build upon the scientific data gathered over the last two decades, data which document health consequences associated with exposures to PCBs. The findings of elevated PCB levels in the U.S. population, together with findings of developmental deficits and neurologic problems in children of mothers who have consumed contaminated fish indicate that the consumption of fish containing PCBs can have significant health consequences. This is true even though overall, the presence of PCBs in the environment is declining.
Also enclosed is a copy of a letter and the brochure, Should I Eat the Fish I Catch?, that ATSDR and EPA are distributing to health care providers nationwide. The brochure was developed by ATSDR and EPA as another part of the Action Plan and is available in three languages (English, Spanish, and Hmong). It is designed to provide information to consumers about how to reduce their exposure to the contaminants found in the fish they eat.
We hope you will use both of these publications to assist you in implementing effective intervention and prevention strategies to address the increasingly significant public health threat.
For more brochures, please contact EPA's National Center for Environmental Publications, 11029 Kenwood Road, Cincinnatti, Ohio 45242. For extra copies of ATSDR's Toxicological Profile, contact ATSDR, Division of Toxicology, Executive Park Building 4, 1600 Clifton Road NE, Atlanta, GA 30333, telephone: 404-639-6300.
For additional information about the program, please contact the EPA Office of Water, Fish Contamination Program (4305), 401 M Street SW, Washington, DC 20460, e-mail: http://www.epa.gov/waterscience/fishadvice/ or ATSDR, Division of Health Education and Promotion, MS E-33, 1600 Clifton Road NE, Atlanta, GA 30333, telephone: 404-639-6204.
J. Charles Fox
Assistant Administrator for Water
U.S. Environmental Protection Agency
Lynn R. Goldman, MD
Assistant Administrator for Prevention, Pesticides, and Toxic Substances
U.S. Environmental Protection Agency
Barry L. Johnson, Ph.D.
Assistant Surgeon General
Assistant Administrator
Agency for Toxic Substances and Disease Registration
