Dave McBride Toxicologist Office of Environmental Public Health Sciences SRRTTF Workshop February 9 2016 Yakima River PCBs Lower Duwamish River PCBs Puget Sound PCBs Mercury Lake Whatcom ID: 1047843
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1. How Fish Tissue Data is Used to Develop a Fish AdvisoryDave McBride, ToxicologistOffice of Environmental Public Health SciencesSRRTTF Workshop February 9, 2016
2. Yakima River*PCBsLower Duwamish RiverPCBsPuget SoundPCBs, MercuryLake WhatcomMercuryLake RooseveltMercury, PCBsLake ChelanDDTSpokane RiverPCBs, PBDEsGreen LakePCBsLake WashingtonPCBsLower Columbia RiverPCBsWenatchee RiverPCBsOlympiaSeattleSpokaneWalla Walla RiverPCBsWashington Statewide Mercury Advisories: Northern Pikeminnow: DO NOT EATLargemouth and Smallmouth bass: 2 Meals per MonthCurrent Fish Advisories in Washington StateOkanogan RiverDDTLower Columbia RiverMercury, PCBsMid-Columbia, Snake RiverPCBs (pending 2016)Bradford Island PCBs Pend OreilleMercury
3. Fish AdvisoriesCR = RfD x BW / Concentration FishNTR CriteriaConcentration Fish = RfD x BW / CRNot used to set Standards Used to set Standards or Screening levels“How much can I safely consume”“How clean do the fish need to be”Applies to everyoneIdeally targets 90-95% consumersLess conservative (use a range of cancer risks, focus on non-cancer endpoints)Conservative (e.g. 1 in 1 million cancer)Attempts to balance risks and benefits and considers “background” and contaminant levels in other foods, etc.Does not consider health benefits of consuming fish – based primarily on riskReactive/Proactive – responding to what is in the environment, prevent exposureProactive/Reactive – before & after contamination occurs (discharge & cleanup standards)Provide adviceTrying to prevent the need for FAsFish Advisory vs. NTR
4. 4Vol. 1: Sampling & AnalysisVol. 2: Risk AssessmentVol. 3: Risk ManagementVol. 4: Risk Communicationhttp://water.epa.gov/scitech/swguidance/fishshellfish/techguidance/technical_index.cfm
5. Fish Advisory in a Nutshell
6. PCBs - Why the ConcernFish are a primary source of exposure to PCBsPCBs known to impact the immune system, cause neurological and developmental problems, and have reproductive effects. Evidence for carcinogenicity in animals, potential carcinogen in humansWe’re all exposed to PCBsPCB detected in serum of 100% of U.S. population sampled 2003-04 by CDC
7. Evaluate Total PCBS based on:Single or combined Aroclors Adding congeners or subset of congenersUtilize EPA’s IRIS values & ATSDR’s MRLNon-cancer Reference Dose (RfD)*Based on Aroclor 1254Minimal Risk Level (MRL)**Dioxin-like TEFCancer – Cancer Slope Factor (CSF)*Based on Aroclor mixturesApproach(es) to PCBs*http://www.epa.gov/iris**http://www.atsdr.cdc.gov/toxprofiles/tp17.pdf
8. Can be developed for cancer and non-cancer endpoints and for differing consumption ratesDOH uses two consumption rates59.7 g/day = 2 meals per weekBased on AHA & ADA recommendationsFish Advisory Action level175 g/day = 23.5 meals per monthBased on proposed FCRFish Advisory Public Health Goal (PHG)Much like Drinking Water Standards, we can have action levels (MCLs) & Goals (MCLGs) but with no regulatory authorityScreening Levels
9. AnalyteRfDNon-cancer(mg/kg-day)CSFCancer(mg/kg-day)-1Tissue SL(59.7 g/day)ppbTissue SL(175 g/day)ppbPCB0.00002-238PCB*0.00003-3010PCB-20.590.20PCB Screening Levels (SL)Noncancer endpointCancer endpoint* Based on MRL
10. Non-cancer Meal LimitsCancer Meal Limits Calculated Meal Limits
11. 12 PCB congeners act similarly to 2,3,7,8-TCDDMultiply relative toxicities (TEF), add to get total TEQ (TEQ = Σ[Ci] × TEFi)Effects thought to be meditated through AhR (aryl hydrocarbon) receptor bindingActivates metabolizing enzymes e.g., Cyto-P450Production of toxic metabolites, gene transcriptionAdverse cellular processes and functionImmuno, reproductive, endocrine, teratogenic, carcinogenicDioxin-like PCBsTEQ Approach
12. Calculated Consumption Rates for Multiple Contaminants with same Health Endpoint ParameterValueUnitsRfD/MRL - Reference Dose PCBs Mercury PBDEs0.000030.00010.0001mg/kg-dayBW - body weight60 (adult ♀)kgCF – conversion factor30.4days/monthMS – meal size0.227kg/mealConc. – concentrationmeanmg/kg
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14. 2007 NAS IOM Seafood Choices: Balancing Benefits and RisksSeafood is nutritious, high-quality protein, low in saturated fat, rich in polyunsaturated fats (Omega-3 Fatty Acids EPA &DHA)Eating fish confers health benefitsPrevention of irregular heart contractionsPrevention of arteriosclerosisPrevents inflammationLower PBPossible reduction of certain cancersHigher cognitive abilities Benefits of Fish Consumption
15. Summary of Evidence of Effects of Consumption of Fish/Fish Oil on Cardiovascular OutcomesOutcomeClinical EffectStrength of EvidenceCHD MortalityCHD deathSudden death*≈ 35% decrease≈ 50 - 90% decreaseStrongStrongIschemic Stroke≈ 30% decreaseModerateNonfatal CHDModest benefit?EquivocalAtrial fibrillation≈ 30% decreaseLimitedCongestive heart failure≈ 30% decreaseLimitedsource: Mozaffarian and Rimm, 2006*Albert CM et al. 2002
16. Emerging Evidence of Effect of Consumption of Fish/Fish Oil on Other Health OutcomesHealth OutcomeReduced preterm birthImproved brain function, motor and visual benefits to infants & childrenSignificantly reduced rates of age-related cognitive decline and dementia, including Alzheimer’s DiseaseSharply reduced incidence of early age-related macular degeneration and late AMDReduced need for traditional anti-inflammatory drugs in treatment of rheumatoid arthritisTreatment or prevention of depression and other mood disorders, including postpartum depression
17. American Heart Association:Patients without documented heart disease:Eat a variety of fish at least twice a weekPatients with documented heart disease:Consume about 1 g of Omega-3 fatty acids (EPA+DHA) per day preferably from fatty fishPatients who need to lower triglycerides:2 to 4 g of Omega-3 fatty acids per dayAmerican Diabetes Association:Eat 2-3 servings of fish per week to lower the risk of diabetesRecommendations to Encourage Seafood ConsumptionNoted in NAS IOM, 2007
18. Dietary Guidelines Advisory Committee Report (DHHS and USDA):“Consumption of two servings (approximately eightounces) per week of fish high in EPA and DHA is associated with reduced risk of both sudden death and heart disease death in adults. To benefit from the potential cardio-protective effects of EPA and DHA, the weekly consumption of two serving of fish, particularly fish rich in EPA and DHA, is suggested.”Recommendations to Encourage Seafood Consumption*Noted in NAS IOM, 2007
19. National Healthy Mothers, Healthy Babies Coalition:Pregnant, breastfeeding and postpartum women are recommended to consume a minimum of 12 ounces of seafood per week (salmon, tuna, sardines), or DHA-fortified eggs. Six ounces of the recommended fish per week can come from albacore tuna.Recommendations to Encourage Seafood Consumption
20. Contaminant RiskOmega-3 BenefitFish ConsumptionOmega-3BenefitContaminant A RiskContaminant B RiskCombined Risk?
21. Decline in fish consumptionAfter federal mercury advisory 1/01fish combinedcanned tunadark meat fishPre-advisoryPost-advisoryObstet Gynecol. 2003;102(2):346-51.
22. BenefitsBackground or ambient levelsContaminants in other foodsRisks posed by other foodsContaminant reduction from preparation and cookingSimplifying messageModifying the Calculated Results to Incorporate Risk Management & Risk Communication Decisions
23. Spokane River Fish AdvisoryUpdate 2009/2016Lake Spokane (Long Lake):Two meals per month:Largemouth & Smallmouth BassOne meal per month: Brown Trout & Largescale Sucker2016 – Carp: No ConsumptionGood fish choices include:2 meals per week rainbow trout, yellow perch1 meal per week - mt whitefishFrom Nine Mile Dam to Upriver Dam: Do Not Eat: Largescale Sucker All other fishOne meal per month From Upriver Dam to the Idaho Border: Do Not Eat FishCatch & Release OnlySpokaneSpokane RiverStatewide Mercury Advisory: Smallmouth & Largemouth Bass – 2 meals/month Northern Pikeminnow – No Consumption
24. 1E-61E-51E-4Non-cancer2380.20.59Background conc. 6.5 ppbNTR Std5.3 ppbPublic Health Goal
25. Eat Fish, Be Smart, Choose WiselyQuestionsDave McBrideOffice of Environmental Public Health Sciencesdave.mcbride@doh.wa.gov(360) 236-3176