Methemoglobinemia Risk Factors: Response to Avery and L'hirondel

Abstract

The article by Knap et al., “Indicators ofOcean Health and Human Health:Developing a Research and MonitoringFramework” (Knap et al. 2002), was awelcome overview of issues that link theenvironmental condition of marine/oceanecosystems and human disease. The comple-ment to the growing concern about theconnection between health and the marineenvironment is a corresponding emphasison large freshwater lake ecosystems andhuman health.In the United States and Canada, forexample, the Great Lakes basin contains a setof inland seas that are oceanographic in scale.They serve as a highway for internationalmaritime commerce and support a $1 bil-lion/year recreational and commercial fishingindustry. In addition, they must also supplydrinking water for over 15 million people. The Great Lakes hold about 20% of theworld’s surface freshwater. In this context,the degradation of the Great Lakes ecosys-tem through chemical and biological conta-mination presents an enormous challenge forthe future. Questions about the impact ofmethyl mercury, polychlorinated biphenyls,and other chemicals on the health of thosewho eat fish from the Great Lakes; about therole of bacterial loading of coastline beacheson disease; and about the quality of drinkingwater taken from the lakes are among thosein need of intense study. Surprisingly, in comparison with thenumber of research organizations and fund-ing opportunities that concentrate on themarine environment, there are very fewgovernmental or academic programs thattarget the Great Lakes environment. In thiscontext, it should be a priority to developresearch programs that can enlarge theknowledge base so that the Great Lakes canbe sustained as the centerpiece of our fresh-water resources.