Abstract
BackgroundIn 2003 mean cord blood mercury concentrations in pregnant Bermudian women exceeded levels associated with adverse health outcomes in children. The principal mercury source was local fish species. Public health messages were developed suggesting pregnant women reduce consumption of fish species with higher mercury concentrations (e.g. swordfish), substituting species containing lower mercury concentrations, and elevated omega-3 fatty acids (e.g. anchovies). Recent evidence indicates mercury concentrations in Bermuda’s pregnant women have fallen five- fold.ObjectivesAssess whether changes in women’s fish eating patterns during pregnancy are consistent with the public health messaging. Determine who is making changes to their diet during pregnancy and why.MethodsMixed methods study with a cross-sectional survey of 121 pregnant women, including 13 opened-ended interviews. Health system, social vulnerability, public health messaging, and socio-demographic variables were characterized and related to changes in fish consumption during pregnancy. Qualitative data were coded according to nutritional advice messages, comprehension of communication strategies, and sources of information.Results95% of women surveyed encountered recommendations about fish consumption during pregnancy. 75% reported modifying fish eating behaviors because of recommendations. Principal sources of information about fish consumption in pregnancy were health care providers and the Internet. 71% of women reported reducing consumption of large fish species with greater mercury levels, but 60% reported reduced consumption of smaller, low mercury fish. No participant mentioned hearing about the benefits of fish consumption. More frequent exposure to public health messages during pregnancy was associated with lower reported consumption. Bermudian born women were less likely to reduce consumption of large fish species during pregnancy.ConclusionsIn Bermuda, public health messages advocating reduced consumption of larger, higher mercury-containing fish species appear effective, but masked the nutritional value message of small fish species, with low mercury concentration. Adjustment is needed to better balance the risk communication.
Highlights
IntroductionIn 2003, our research team, as part of the Atlantis Mobile Laboratory visit to Bermuda, documented elevated mercury concentrations in the cord blood of pregnant women; 60% of samples were above the contemporaneous United States (U.S) Environmental Protection Agency guidelines for mercury in cord blood (30nmol/L or 5.8 μg/L) [1]
In 2003 mean cord blood mercury concentrations in pregnant Bermudian women exceeded levels associated with adverse health outcomes in children
In 2003, our research team, as part of the Atlantis Mobile Laboratory visit to Bermuda, documented elevated mercury concentrations in the cord blood of pregnant women; 60% of samples were above the contemporaneous United States (U.S) Environmental Protection Agency guidelines for mercury in cord blood (30nmol/L or 5.8 μg/L) [1]
Summary
In 2003, our research team, as part of the Atlantis Mobile Laboratory visit to Bermuda, documented elevated mercury concentrations in the cord blood of pregnant women; 60% of samples were above the contemporaneous United States (U.S) Environmental Protection Agency guidelines for mercury in cord blood (30nmol/L or 5.8 μg/L) [1]. Eighty-five percent of the mercury analyzed in cord blood was methylmercury, indicating that fish consumption was the primary exposure route [1, 2]. Recent research observes associations between prenatal mercury exposure and shortened gestation resulting in reduced newborn birth weight, length and head circumference [4]. In the 2003 study from Bermuda, our research established a mean cord blood mercury concentration of 8.3 μg/l (range 1–32.1 μg/l) [5]. Research from Northern Canada in a population of school-age children, documents adverse effects on behaviour [6] and cognitive function [7]- including intellectual disability [8]- associated with prenatal mercury exposure at concentrations observed in Bermuda in 2003. In 2003 mean cord blood mercury concentrations in pregnant Bermudian women exceeded levels associated with adverse health outcomes in children. Recent evidence indicates mercury concentrations in Bermuda’s pregnant women have fallen five- fold
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