BELTSVILLE, Md., July 23 —  Pregnant women are urged not to eat four types of fish that could contain enough mercury to hurt an unborn baby’s developing brain. But should tuna or other species be on the do-not-eat list

THE FOOD and Drug Administration says a few servings a week of most fish is safe. But critics charge the FDA watered down its tuna advice after seafood industry lobbying — and should have considered other worrisome fish — and thus left tens of thousands of babies at risk of learning disabilities.  The FDA insists its advice wasn’t tainted, but asked its independent scientific advisers to judge whether it erred and if American women need stronger fish warnings.

“It was our genuine belief that if women consciously followed this advice ... these women would be protecting their unborn children,” FDA food safety chief Joseph Levitt said Tuesday as the advisers opened the three-day inquiry, an inquiry taken so seriously that FDA acting commissioner Lester Crawford attended. “It is an emotionally charged issue,” Levitt acknowledged. “We are truly open and want your best advice, whether you agree with us or not.”  The panel will issue a decision on Thursday.  Fish is very nutritious; certain types contain high levels of heart-healthy fats, plus fats important for fetal brain development. But different types also harbor different amounts of toxic mercury. Typically, the largest fish contain the most mercury.

Based on loose figures about U.S. fish consumption, some 60,000 newborns a year might be at risk of neurologic damage because of mercury their mothers absorbed during pregnancy, the National Academy of Sciences says. RISKY MERCURY LEVELS  About 8 percent of U.S. women of childbearing age have enough mercury in their blood, based on the academy’s levels, to be at risk, says the Centers for Disease Control and Prevention. Those who eat three or more servings of fish a week had the highest levels.

Last year, the FDA advised:
Pregnant women, and those wishing to become pregnant, should not eat shark, swordfish, king mackerel or tilefish (also called golden snapper) because they contain high mercury levels. Those women can safely eat up to 12 ounces of any other cooked fish a week —from canned tuna to shellfish to smaller ocean fish. Critics immediately attacked the FDA for not including tuna steaks, which contain somewhat less mercury than swordfish.

Some groups also urge pregnant women to curtail canned tuna consumption, although canned tuna is made from small tuna fish that contain far less mercury. And some advise pregnant women to avoid other species, such as sea bass and marlin. The result is mass confusion — women don’t know what to believe, consumer advocate Caroline Smith DeWaal of the Center for Science in the Public Interest told the FDA advisory panel.
      
NO WARNING LABELS
Worse, she said, the FDA doesn’t prevent the most heavily contaminated fish from being sold. Nor does it require warning labels on the fish pregnant women aren’t supposed to eat, making it difficult for consumers to know the advice. “It truly is a toothless tiger,” she said.  Another advocacy organization, the Environmental Working Group, says it created a model of what would happen if pregnant women followed FDA’s advice, and concluded that up to 1 million a year could be exposed to worrisome mercury levels. The FDA strongly disagrees, saying it can’t validate the activists' model.

A seafood industry consultant argued Tuesday that the risk has been inflated mostly because women eat far less fish than has been estimated. The FDA deems fish safe if they contain less than 1 part per million of methylmercury; the four types on its do-not-eat list exceed that level. Critics charge large tuna steaks can contain more, too, and certain other species contain only slightly less.  One of FDA’s own advisers said Tuesday that he bought 11 cans of tuna fish at his grocery store, and independent testing showed one of them contained 1.2 ppm of mercury.

How much mercury exposure is too much is controversial. There are two competing studies: Babies born in the Faroe Islands in the North Atlantic, where people eat lots of highly contaminated whale meat, have a higher risk of certain defects in memory and learning. Babies in the Indian Ocean’s Seychelles Islands seem to suffer little effect. Women there eat mostly the same fish Americans do, but so much that their bodies contain 10 to 20 times more mercury than Americans’.
 

http://news.bbc.co.uk/1/hi/health/2276733.stm

Infertility linked to mercury in seafood

Raised levels of mercury in the blood, from high seafood consumption, are linked to infertility, researchers have found. The study was carried out in Hong Kong, where people eat a large amount of seafood, and where seas have high levels of pollution. In the UK, people eat less seafood and there is less pollution. But UK experts say the Hong Kong findings show the effect environmental pollutants can have on fertility. Mercury is one toxin thought to have an impact on fertility. Researchers from The Chinese University of Hong Kong studied 150 infertile couples undergoing IVF, and 26 fertile couples.

Blood tests were used to assess the level of mercury in the men and women's system. A dietician also asked infertile couples about their seafood consumption. Other potential sources of mercury, such as fish pill supplements or the use of skin-lightening cosmetic creams were also recorded. Overall, the infertile group had significantly higher blood mercury concentrations than the fertile group. Over a third of infertile men had abnormally high concentrations, as did 23% of infertile women.

The researchers point out that women who are exposed to mercury through their jobs can have irregular periods. Writing in the British Journal of Obstetrics and Gynaecology, the researchers led by Dr Christine Choy, said: "While comparing infertile subjects having abnormally high blood mercury concentrations, seafood consumption was the only different source of exposure to mercury among various other sources." They add that contamination of the waters around Hong Kong with heavy metals is common.

A recent study in Thailand which looked at 10 samples of shark's fin found six had concentrations of mercury above the upper safety limit for human consumption. Tuna and swordfish, which are predatory fish, may also accumulate high concentrations of mercury. The researchers add: "Reduction in dietary consumption of seafood is a measure that may be effective in controlling the accumulation of mercury. "However, this should be balanced against the beneficial effects of other components of fish, such as those of 3-omega fatty acids and selenium."

Bill Ledger, professor of obstetrics and gynaecology at the Royal Hallamshire Hospital, Sheffield, said though the Hong Kong findings did not apply to the UK, there were lessons in terms of the effect of environmental pollutants. "It's different in Hong Kong, where they eat a huge amount of seafoods and the seas there are highly polluted. "People in the UK just don't eat as much seafood. "You would have to have seafood at least three or four times a week." But he said it did show how environmental pollutants could affect fertility and the impact of long-term exposure. "For example, working in Sheffield, I see a number of males with low sperm counts because they are working every day with pollutants, such as solvents. "They are exposed all day every day. People doing some DIY, that's not a problem."
 

http://www.sdearthtimes.com/et1202/et1202s17.html

Doctor links ailments to consumption of mercury laden fish Internal medicine specialist and her patients say they see direct relationship between fish consumption, high mercury levels and bizarre ailments by Ben Rrines, Mobile Register, Staff Reporter Jane Hightower, one of San Francisco's leading internal medicine specialists, a physician to rock stars, actors and writers, was at a loss to explain the unusual ailments afflicting her most health-conscious patients. Heart tests, CAT scans, spinal taps and blood work showed only that the patients took good care of themselves.

    Yet clearly they were sick.

    A surgeon had tremors so bad she was afraid she'd have to give up operating. A geophysicist said he couldn't think anymore and was unable to do even simple subtraction. A mother, father and child living on a ranch in the rolling hills of wine country were losing their hair.  Ultimately, there were about 200 patients, dotted all over the hills around San Francisco, most enjoying the good life complete with nannies and private yoga instructors and sweeping views of the Golden Gate Bridge.

    They were scientists, surgeons, CEOs, psychiatrists, wine-makers, writers and children, and the only thing they seemed to have in common were the persistent symptoms – including severe memory loss, depression and a strange metallic taste in their mouths – that might have a hundred causes but would not respond to any treatment.  Now, in a diagnosis rattling experts in San Francisco's medical community and beyond, Hightower has determined that all of those patients were suffering from mercury poisoning, and the mercury came from the fancy fish they ate.

    She was set to present a paper describing her findings at a Vermont conference called “Methylmercury Contamination in Fish: Human Exposures and Case Reports,” sponsored by the US Environmental Protection Agency, the U.S. Centers for Disease Control and the American Academy of Pediatrics, among others. The paper has been reviewed by her scientific peers and will be published in Environmental Health Perspectives, a medical journal produced by the National Institutes of Health.

    Last year, Mobile Register-sponsored testing of 65 fish consumers on the Gulf Coast revealed that many
had mercury levels some five to 10 times higher that the EPA's safe level. But would people with such mercury concentrations actually suffer ill effects? The scientific data was not definitive. Hightower believes her work cuts through many of the ambiguities, and should cause concern anywhere that people eat large predator fish such as grouper, tuna, amberjack and swordfish.

    “Jane's patient base is quite convincing in terms of exposure,” said Kate Mahaffey, the EPA's top official regarding mercury, who has visited Hightower's clinic. “Now, it's time for scientists and physicians to study the effects she describes. In the exposure range she describes, we simply don't have a lot of published medical evaluations.” Hightower and her colleagues have linked sometimes devastating health problems to the consumption of tuna, Chilean sea bass, grouper and other popular fish known to have high levels of mercury in their flesh. Some women were found to have transferred excessive mercury to their infants solely through their breast milk.

    Treating patients with elevated mercury levels since 1999, Hightower and doctors working with her observed a suite of health effects including depression, loss of scalp hair, metallic taste, headaches, arthritic pain in joints, irritability, tremors, and numbness and tingling in hands and feet. She also described cognitive problems such as pronounced memory loss, confusion and difficulties in talking. In some cases, those problems were so severe they interfered with the ability to earn a living or attend school.

    In every case, the doctors say there have been dramatic improvements in the health of patients within a few months of cutting fish from their diets. “The symptoms my patients were reporting are consistent with symptoms reported in medical literature from around the world when it comes to mercury poisoning,” Hightower said. “I'm just a doctor that happened onto this, but it's so clear. When we pulled fish out of the diet, the mercury levels came down and the symptoms went away. In medicine, that's about as good as it gets for proving something is the culprit. And we've seen it over and over again.”

    Alan Stern, a New Jersey researcher, noted mercury authority and a member of the National Academy of Sciences, said he would have a “healthy skepticism” when looking at Hightower's clinical findings at this weekend's conference. He also warned that the satellite of symptoms described by Hightower's patients could have a number of causes.  Still, he said of Hightower's findings, “I believe this is possible, but we don't have a lot of data. I'm not aware of any data that addresses the effects of low level adult exposure, so I'm very curious.”

Hunting for symptoms  “'You're crazy,' that was the most common diagnosis of these people before their mercury levels were known,” Hightower said. “They had all these symptoms and it looked like they were making it up because no one could find a reason.”  Hightower admits that she stumbled onto the fish and mercury connection after the ranch family members losing their hair were referred to her by Dr. Kathy Fields, a dermatologist who works in Hightower's medical group.

    “I had heard on National Public Radio that heavy metals could make your hair fall out, so I ran a metals test on them,” Fields said. “I called Jane and said, 'I've got this wild mercury level, see what you can do.'”  The family had extensive environmental testing performed on their property, searching for a mercury source in their well water, on their land and in their home. There was no mercury to be found. On a hunch, Hightower asked about their diet and discovered they ate a lot of seafood, particularly big fish such as tuna and swordfish.

    The wheels turned and Hightower picked up the phone and started calling some of her patients. “I'm driving down the freeway and Hightower calls me and says, 'How much fish do you eat?' It was the weirdest thing,” said Will Smith, the geophysicist forced to quit work when his symptoms were at their worst. “I was eating tuna all the time, for lunches, business dinners. I was eating sushi a lot and canned tuna several days a week as a snack. I told her and she said, 'I think it's mercury.'”

    Among patients who showed mercury-related symptoms, Smith's situation was the most extreme. But a few ailments were common to all. “The metallic taste, that was ever present,” said Smith. “My speech was severely impacted, slurred, so was my memory, my balance. I couldn't watch TV because I became dizzy. I was always losing my car. I had tremors. I was always tired. I couldn't concentrate.” Hightower told Smith to cut fish out of his diet and he started getting better almost immediately, though it has been a long, slow process. Neurological testing has revealed that he suffered permanent damage to the parts of his brain that control executive functions. Doctors said the type of brain damage Smith has is almost exclusively associated with heavy metal exposure.

    Doug Anderson, the San Francisco psychiatrist who treated Smith for depression, said Smith routinely left his keys or jacket at his office after their sessions and frequently got lost in a city he has lived in for decades.  Anderson noted that Smith got progressively better as the mercury left his system. “That is the most logical culprit,” Anderson said as a cable car clanged past his row house office. “The fish seems to be the most likely agent.” He has treated a number of Hightower's patients.

    “For someone to come in with major cognitive problems like Will had, we always look for treatable causes. At the bottom of a long list of potential things are pesticides and heavy metals,” Anderson said. “At this point, if people eat significant amounts of fish, they should be tested – if you have a depression that doesn't clear up quickly with traditional treatment like Prozac, if there are cognitive deficiencies. Some people just feel low. They may not be melancholic, tearful or suicidal, but they have a pervasive sense that they can't function.”

    A plastic surgeon, who spoke to the Register on condition of anonymity, had symptoms similar to Smith's, though she rarely ate fish. In fact, her seafood diet was limited to fresh tuna steaks two or three times a month, she said. Yet her mercury level was six to seven times the EPA's safe level.   “My hair was just falling out,” said the surgeon, who described herself as a “meat and chicken kind of girl. I had tremors and numbness and tingling in my hands and feet. And I had serious memory problems. I've always had an excellent memory, that's what got me through medical school. But all of a sudden, I couldn't remember who I had operated on the week before. Literally.”

    Hightower made her give up the tuna, and the mercury level came down within months. The surgeon said the symptoms just disappeared. Not all of the patients were adults, and Hightower and Fields said the effects in children may be the most long-lasting. “In an adult, you can have a recovery, because the brain is already formed. But in a child, mercury affects the migration of nerve cells, and it kills them. It's tragic. We're talking about permanent damage,” Fields said.

    Recently, articles in national publications have noted an increase in autism among children, an increase some have linked to mercury contamination of a preservative – Thimerosal – commonly used in vaccines. Hightower said that among the children she has treated, Thimerosal was ruled out as a possible source of mercury, either because the kids had never received it, or because it had been several years since their vaccinations. All of the children, however, had been exposed to fish known to be contaminated with mercury.

    A 7-year-old boy who ate canned tuna, fresh tuna and king mackerel regularly from the age of 3 was found to have a mercury level 15 times the EPA's safe level. After eight months without fish, his mercury
level had dropped to within the normal range, but it was too late. Hightower said extensive  neuropsychiatric testing confirmed that he suffered some degree of permanent brain damage. After passing all normal developmental milestones up to around age 3, when he began eating fish, the boy showed a severe decline in mental development. His mother said he quit socializing with others, was no longer able to express complete thoughts and couldn't remember classmates' names.

    “Up until we stopped the fish, he was just completely in a fog. He would sit there, all by himself, totally lost,” said his mother, who did not want to be named in order to protect him. “It's just horrifying, because with better information from the government, we could have prevented this. I was even eating fresh tuna when I was pregnant, you know. My son's improved, steadily and markedly, since we got him off of fish, but he's not fully recovered and I don't know that he ever will be. Still, he can communicate now, and he can make friends again.”

    Four-year-old Sophie Waldman lives in Berkeley with her parents, novelists Ayelet Waldman and Michael Chabon, a Pulitzer Prize winner. Sophie, her mother said, loves canned tuna and used to eat tuna sandwiches a couple of days a week.  “Sophie was an early walker and an early talker,” Ayelet said, curled up on a couch in her dark and woody Berkeley bungalow. “Then she sort of slowed down. She was starting to tie her own shoes and then all of a sudden, she couldn't do it anymore. And she was sounding out words, then she couldn't do it anymore. And her hair was really weird. It wouldn't really grow and felt strange.”

    When Hightower pulled her off of fish, she got better. “When her mercury level came down, she could tie her shoes again and was suddenly able to read. She had this huge developmental upsurge, after a year of being sort of stagnant,” said Waldman, a Harvard-educated former public defender. “I'm not some Berkeley-mom-food-Nazi. My kids live off sugar, you know. But, I saw a difference in my kid. Simple as that.”

Multiple forms of exposure  Fields and Hightower said they found that their patients were exposed to mercury in three major ways: Adults and children ate popular fish such as fresh tuna.  Fetuses were exposed as a result of the mother's fish consumption.  Infants nursed from mothers with high mercury levels.  In the case of one patient, the only apparent source of exposure was fish oil supplement pills.  Hightower said symptoms can occur in patients with high mercury levels as well as in patients whose mercury levels fall within the “safe” range set by some federal agencies. Although all patients with symptoms had mercury concentrations in excess of the EPA's safe level, many showed effects when their mercury concentrations were below the US Food and Drug Administration's safe level, which is four times higher than the EPA's.

    She said some patients with highly elevated mercury levels were symptom-free. Hightower suggested that people may have different thresholds for mercury in their bodies. “It's important not to get too hung up on the levels. We've found the absolute mercury level does not correspond to the number of symptoms or their severity. The symptoms are what's important, and they can occur at any level,” she said. “Think of mercury like a bee sting. You know, some people will die from one bee sting. Others can handle 40 stings or 100 stings, but everybody has a threshold where the bee stings will kill them. What kills you isn't the bee sting. What kills you is your body's reaction to the bee sting. I think that's the way mercury works.”

    Fields said that as more doctors learn of Hightower's work, it's likely they will begin to diagnose mercury poisoning in patients who eat a lot of fish and have similar symptoms that cannot otherwise be explained. “Our mercury is no different than anyone else's,”said Hightower. “I'm just a doctor who happened to discover these mercury levels in my patients.”  Similar levels have been documented in research literature in places as diverse as Washington state, Wisconsin, Maryland, New Jersey and California.

    “This is afflicting the people who are doing what they are supposed to do, eating a lot of fish to get those Omega-3 fatty acids that are good for your heart. The problem is, it turns out these big popular predator fish have a contaminant in them: mercury,” Hightower said. “It's not how much fish you eat that's the problem, it's what kind of fish you eat. If you are eating a fish that is bigger than the pot you are cooking it in, get a smaller fish, not a bigger pot.” She continued, “People are buying steaks of tuna or swordfish or amberjack or whatever these days. The steaks have no bones, they are easy to prepare and the fish taste good. The problem is they have so much mercury...

    “I've seen in my patients that mercury levels can fluctuate up and down weekly based on what they ate and what day of the week they ate it. And guess what? Their symptoms can come and go like clockwork based on when they ate fish.” Several women in the group were found to have transferred excessive amounts of mercury to their infants solely through breast milk. One breast-fed baby had three times the EPA's safe level for mercury by the time he was 4 months old.

    Jeanine Harmon breast-fed her child twice a day and fed him salmon and sole frequently. By the time he was 19 months old, he was found to have four times the EPA's safe level for mercury. Harmon, whose son is one of Hightower's patients, said she ate canned tuna a couple of times a week during and after pregnancy and worries she may have caused her son permanent brain damage. “He seems fine now, but I'm an elementary school teacher. If he's going to have cognitive problems, they may not even show up until third grade,” Harmon said. “It was horrifying, knowing I couldn't get it out of my baby's body. It's unnerving knowing he had such a high mercury level for so long as he was growing, when his brain was building.”

    Dr. Leslie Kardos, an obstetrician who works in the same building as Hightower, was tested for mercury five months after her baby was born. She had mercury concentrations more than three times the EPA's safe level. Her infant daughter was twice the safe level, her sole exposure through her mother's breast milk. “I'm terrified because I know mercury exposure is linked to a lessening of the IQ, and here I was feeding it to my baby in my breast milk,” Kardos said. “I had to pump and dump my milk for three months because I didn't want mercury in my milk. You know, I'm buying fish in good places, it looks good, and yet it's poisoning me. Clearly the government is not doing its job here.”

    Her fellow obstetrician, Heidi Wittenberg, discovered a number of her pregnant patients had excessive mercury levels and agrees with Kardos that the government has let the public down.  “When my patients ask me if canned tuna is OK, I tell them no. If they want to get pregnant, I tell them to eat fish once every two weeks. No more,” Wittenberg said. “They say we're scaring people unnecessarily but the truth is the government has no idea. Where is the FDA? Why hasn't the NIH funded a study? If you're finding these levels in average Americans, how can you not address it?

    “Here I am, I'm not drinking wine, I'm not doing drugs, I'm not eating cheeseburgers and yet I'm hurting my baby. These are smart people, doing heart-healthy things and they are hurting themselves or their babies,” Fields said. “This is life-changing stuff.”  Hightower said that in her view the government can't afford to duck the mercury problem any longer.

    “All I can say is I saw this in the field. I'm in the trenches with the patients. Now, it's time for the scientists to do the big studies and see if there are correlations,” Hightower said. “It's really sad and distressing. We don't want to lose our tuna, but if people get ill for a long time and they cut it out and feel better than they have in years, they'll quit eating fish. Especially if they go back and eat some and feel sick again.”
 

FDA changes course on mercury policy

Sea change likely to affect fish-consumption advisories nationwide

04/04/03

By BEN RAINES
Staff Reporter


In what leading scientists describe as a landmark change in the government's regulation of mercury, a senior U.S. Food and Drug Administration official says his agency now uses the U.S. Environmental Protection Agency's much lower safe level for mercury in the human body.

Previously, the FDA had maintained there was no danger in having four times more mercury in the human body than the safe level set by EPA. The reversal, along with other policy shifts described by the FDA in an inteview this week with the Mobile Register, will likely affect the mercury advisories issued by states for recreationally caught fish. It will almost certainly lead to significant changes in the ad vice the FDA gives to women and children about what fish are safe to eat.

Some regulators say the FDA's stance also may indicate that the agency plans to provide fish-consumption advice for men, who are not included in the agency's current warning, which targets only women and children. A paper in this month's Journal of the American Medical Association represented the first outward sign of the FDA's new position. The paper was written by top officials from the FDA, the EPA, the Centers for Disease Control and Prevention, and the National Oceanic and Atmospheric Administration.

"This is really a landmark paper," said the EPA's Kate Mahaffey, who helped author the article. "It's really a consensus on what we know about mercury." Both the FDA and the EPA have a role in protecting the public from ingesting too much mercury from contaminated fish. The EPA, which has a larger mission of protecting the nation's natural resources, investigates and regulates various contaminants, including mercury, in recreationally caught fish.

The FDA is charged with protecting the nation's food supply, including regulating how much mercury is allowed in commercially sold seafood. The FDA's former position regarding the safe level of mercury is well-documented in official publications and has caused longstanding disagreement between that agency and the EPA. In fact, during a public meeting discussing the FDA's mercury policy last July, the EPA's Mahaffey and the FDA's Mike Bolger, whose name appears with Mahaffey's on the new paper, got into a terse and heated argument while discussing the science behind the safe level or "reference dose."

During that meeting, an internal FDA panel challenged the agency to publish a scientific rationale for its higher safe level. That has not happened, and now the FDA is taking pains to distance itself from its old position. "Right now, the FDA is not making that statement," said Dr. David Acheson, the newly appointed chief medical officer in the FDA's science office. "Whether they did in the past, I don't know. That may have been based on past thinking."  Leading mercury researchers around the nation expressed surprise when told of the FDA's change.

"If the FDA is now cooperating closely with the EPA and they are on the same page, this makes a very big difference not only in terms of government policy for commercial seafood, but it provides great clarity for states on how they should handle their mercury advisories," said Alan Stern, who coordinates mercury research for the state of New Jersey and who served on the National Academy of Sciences panel that studied and endorsed the EPA's safe level.

"This is really like a sea change at FDA," Stern said. Acheson did not equivocate when asked if the FDA endorsed the EPA's safe level. "The FDA is basing its advisory on the EPA's reference dose," Acheson said. "Are we formally endorsing it? I'm not aware, but we are certainly using it and pay attention to it."  The new thinking appears to extend to some other contentious topics the agency has been wrestling with.  Acheson indicated that the FDA plans to add more fish to its so-called "Do Not Consume" list if new mercury testing reveals that a species tends to have a high level of mercury. Now, there are only four fish on the list: swordfish, shark, tilefish and king mackerel. Environmental groups have accused the agency of caving in to pressure from the fishing industry instead of listing additional fish that scientists believe have high mercury levels.

Mercury tests of fish by the Mobile Register in the last two years revealed that a number of species -- including grouper, amberjack, redfish, cobia and yellowfin tuna -- may contain so much mercury they would qualify for the FDA's list. Also, the Register has shown that the mercury databases used by the FDA for selecting the fish on its list are fun damentally flawed. EPA scientists have described the FDA data as essentially useless for determining whether a species is safe to eat.

As a result, the agency may have underestimated the mercury levels in many popular species. The National Marine Fisheries Service is in the process of testing 2,500 samples of Gulf of Mexico fish for mercury. The fisheries agency plans to test Pacific and Atlantic fish as well. "If the data demonstrates that other fish should be put in that category, then I think we would add more fish to the list," Acheson said. He also said the agency was reconsidering the advice it gives to women and children regarding how much canned tuna is safe to eat. The FDA's current advice states that women and children are safe eating two cans of tuna a week.

Scientists say that two cans of tuna a week would push a 130-pound woman over the EPA's safe level. In fact, just over one can a week would contain all the mercury a 130-pound woman could safely handle, according to EPA calculations. As little as half a can a week could push a 4- or 5-year-old child over the safe level. "We have these things under consideration right now in regards to canned tuna," Acheson said. "What FDA is doing is trying to keep its advisory apace with the science and the data."

 

FDA Denies Any Change in its Methylmercury Guidelines, Issues Statement on
Web site

http://www.seafood.com/news/current/92533.html

Seafood.Com News - [FDA statement] Contrary to some recent news reports, the Food and Drug Administration (FDA) has not issued a new advisory on methylmercury consumption. FDA's current advisory regarding methylmercury and fish consumption still stands. </more> The current advisory, issued March 2001, recommends that pregnant women and women of childbearing age who may become pregnant not eat shark, swordfish, king mackerel, and tilefish. Also, as prudent public health advice, FDA also recommends that nursing mothers and young children not eat these four varieties of fish because of the relatively high levels of methylmercury they may contain. The current advisory acknowledges that seafood can be an important part of a balanced diet for pregnant women and women of childbearing age who may become pregnant. Further, the current advisory provides that pregnant women and women of childbearing age can safely eat 12 ounces per week of a variety of other kinds of cooked fish (typical serving size of fish is from 3 to 6 ounces).

FDA's believes that women following FDA's advisory would generally be below the Environmental Protection Agency's (EPA) reference dose for methylmercury. FDA received a number of recommendations from its Food Advisory Committee last summer on how to improve this advisory. FDA will continue to work closely with EPA and others in developing the best science-based approaches to dealing with methyl mercury in fish.
* * *
 

http://www.guardian.co.uk/food/Story/0,2763,1120569,00.html

Has fish had its chips?

If you have suddenly lost your appetite for salmon, don't get too fond of the other options. Trouble is brewing for all farmed seafood, reports Stephen Khan

Sunday January 11, 2004
The Observer

Stacks of salmon steaks and fillets remained on ice at Chapel Street Market in Islington on Friday. Only weeks ago ago they were disappearing at a record rate, destined for millions of festive dinner tables. Now shoppers flashed a concerned glance and passed by. Farmed fish was having its mad
cow moment. Just as BSE research prompted an EU ban and shoppers' boycott of beef almost eight years ago, now public confidence was being rocked in the very foodstuff nutritionists have been telling us we must eat more of.

Salmo salar, the Atlantic salmon, is no stranger to health scares. Rarely has a month passed in recent years without a television programme or a feature in a magazine raising concerns about aquaculture, the fastest-growing sector of the global food economy. But Friday was something different.

This was not some fringe pressure group or band of tree-hugging environmentalists out to rattle cages. It was some of the world's leading experts on industrial pollution. And what they had to say was devastating: farmed salmon was poisonous. What's more, the most dangerous fish of all were salmon raised in Scotland.

Researchers based at the University of Albany in New York revealed in the journal Science how they found high levels of contaminants such as PCBs, dioxins and pesticides in Scottish fish, which is marketed around the world as a premium product. Eating more than three portions a year, they warned, risked increasing the consumer's chances of developing cancer. 

In Britain, 99 per cent of salmon sold in fishmongers and supermarkets comes from Scottish farms. They moved swiftly to assuage customer fears but the impact of the findings already appears to have been powerful. Across the UK this weekend sides of smoked pink fish 'fresh from the crystal clear waters of Scotland' sat untouched on shelves alongside curiosities such as salmon nuggets and tikka bites. Staff in one branch of Tesco near Glasgow estimated that the store was shifting less than half its usual stock of farmed fish.

Back at the Islington market in London, Jamie Curtis revealed that sales had nosedived. 'I've had people coming up to me all day,' he said. 'A lot of customers have been saying that since hearing the news about the risks associated with eating salmon they're going to give it up for good.'

On hearing details of the American research, one shopper considered ditching her purchase. Nicola Burn, a 30-year-old teacher, said: 'If I had known about it I'm not so sure I would have put this packet of salmon in my basket. I'll definitely be reading the labels on fish more carefully from
now on.'

Reactions like this will distress Scottish fish farmers as they begin the mammoth task this week of attempting to rebuild public trust. For them - and for Britain's baffled consumers - further confusion and uncertainty lie ahead.

The intensity of their reaction to the revelations is a clear indication of just how worried fish farmers are. In Scotland alone the business is worth £700 million and supports more than 6,500 jobs - mainly in remote areas with a history of high unemployment.

The country's 300 salmon farms produce 160,000 tonnes of fish a year. Industry representatives insisted farmed salmon was safe and claimed the American team's report was misleading. They called on support from the Food Standards Agency and politicians, who are well aware that aquaculture accounts for half of the value of all Scottish food exports.

Much of the blame for the high contamination readings has been heaped on the feed used to raise the fish. Environmentalists have long criticised this aspect of the industry as it relies on wild fish being caught and ground into pellets to feed their captive cousins. They have pointed out that it takes three tons of wild fish to produce one ton of the farmed variety. It is, therefore, fundamentally an unsustainable industry.

Now the research published in Science suggests that this feed, harvested from the polluted waters of the North Sea, results in the fish farmed in the area being more contaminated than those elsewhere. Aquaculture critics had already pointed out that the polluted waters of the northern hemisphere produce farmed fish with contamination levels eight times greater than those in the southern hemisphere farms of Chile, Australia and Africa.

The world's largest producer of salmon feed is EWOS, based in Bathgate, West Lothian. Managing director Neil Spreckley yesterday defended the business and said it was constantly seeking to improve methods. 'Industrial pollution is not as bad as it was 20 or 30 years ago. The raw materials going into fish feed have improved. We are trying to formulate more ingredients which are lower in PCBs and dioxins such as soya and linseed vegetable oils. The problem is that salmon's natural diet is to eat fish.' 

And that, say anti-aquaculture campaigners, is the problem with the entire industry. What we are witnessing with salmon now will be replicated across the dozens of other carnivorous species being reared in captivity around the world.

Projections indicate that by 2020 more farmed fish will be eaten than those caught in the wild. Already aquaculture is worth more than £30 billion a year globally and the number of species that ate being developed is rapidly increasing.

Like salmon and trout, the vast majority of sea bass and bream consumed in Britain comes from farms. Mediterranean countries such as Greece have raced ahead in the production of such species that require warmer waters. Tuna is also being developed, and the Japanese have even floated the idea of a huge minke whale farm.

Here and in Norway, though, all eyes are on halibut and cod - the great hope of aquaculture. Proponents say that both offer the prospect of cleaner, more sustainable farming than salmon.  One person who won't be serving any of them, however, is Jackie MacKenzie  who worked at a fish farm in the north-west of Scotland for three years in the 1990s before quitting over concerns that the chemicals he was using were having a detrimental effect upon his health.

'There used to be fresh salmon on the table when I was a boy,' he told The Observer. 'But that was a different fish to what we get now. I wouldn't feed my children the stuff that comes out of these farms.' He claimed that the aquaculture industry had taken a quality product and turned it into 'gunk'. Wild salmon, he said, was a firm, muscular, healthy fish. What now masqueraded as the king of fish was a flabby, dyed-pink beast that bore little resemblance to its wild relative.

He warned that it was inevitable that other species would develop problems in captivity. 'All fish have their diseases, and when you cram lots of them into a confined space it is inevitable the disease will spread. Then chemicals are introduced in an attempt to control things.'  Along with feed and chemicals, MacKenzie lists escaping fish as one of the main, unavoidable problems of sea-cage fish farming. Wherever there are fish in captivity, there are jailbreaks. Inevitably, wild populations are affected. A Pacific salmon from farms in contaminated waters off the north-west coast of Russia was recently found in Scotland.

Diseases are passed on, and cross-breeding has resulted in deformities and genetic mutations that have seen a stark drop in wild salmon stocks since farms arrived in Scotland in the late 1970s. 
MacKenzie and other anti-aquaculture campaigners welcome the Albany report, claiming that for years they were seen as crackpots standing in the way of progress. 'Finally the concerns we have are being recognised by others,' said the ex-fish farmer.

The revelations in the journal Science come as it is revealed that 27 imports of smoked salmon were last year condemned by the powerful US government watchdog, the Food and Drug Administration, as unfit for human consumption following random checks.

These included 15 shipments of smoked salmon which were turned away because they were contaminated with listeria and a further nine salmon shipments from Scotland which were classified as 'insanitary'.  In Britain, a million Scottish-farmed salmon a week were sold during the
Christmas period. Thousands more trout, sea bass, sea bream and cod that lived and died in captivity were also eaten. None, however, passed the MacKenzie family's lips. It appears that many more families up and down the country are now following their lead.

· How fish are farmed

Atlantic salmon
Main producers are Norway, Chile and Scotland. Worldwide production exceeds one million tonnes a year. Between 5,000 and 50,000 fish are held in sea cages. The colourings astaxanthin and canthaxanthin are used to dye flesh pink. Fish are treated with antibiotics, injected with vaccines and fed on fishmeal and oil extracted from 'trash fish' living in polluted waters. As a result, farmed salmon contain carcinogenic PCBs, dioxins and mercury as well as pesticides.

Rainbow trout
Raised in France, Italy, Denmark and the UK. Britain produces 35 million fish a year. As with salmon, antibiotics, vaccines and colourings are heavily used.

Cod
Norway hopes to farm 10,000 tonnes this year. Like salmon, the fishmeal fed to cod contains PCBs, dioxins and other pollutants. Stocking densities in cages are similar to salmon, with higher mortality rates.

Halibut
Production in its infancy, led by Norway followed by Iceland and Scotland. Reared on a diet of live plankton, followed by fishmeal pellets, they are exposed to the same drugs, pollutants.

Sea bass/sea bream
Greece accounts for 60 per cent of European production. A temperatures of 20C is required, hence the proliferation of warm-water bugs.

Tuna
Mainly farmed in Spain, Croatia, Italy and Malta to supply Japan. In 2001, just 12 Mediterranean farms produced 11,000 tonnes of bluefin - half the global total.

Turbot
Production is centred on France, Spain, Ireland and Scotland and totals 6,000 tonnes. The breeding cycle of turbot is similar to that of halibut, and farmers use similar technology. Viral haemorrhagic septicaemia led to the closure of a farm on Gigha in 1994.

· Other food health scares

Kiwi fruit
Despite its famed health benefits, it was found to make two-thirds of children ill when they ate it for the first time. According to a report published in May 2003, symptoms ranged from a tingling in the throat to severe wheezing and collapse. The Food Standards Agency advised parents to be alert.

Potatoes
Fried and oven-baked potatoes were reported to contain dangerously high levels of acrylamide, a substance that might cause cancer. In April 2002, researchers in Sweden reported that the chemical was formed when foods that contain carbohydrate, such as potatoes and cereals, a re-fried or baked at high temperatures (above 120C).

Coffee
In addition to the known risks of a high caffeine intake, pregnant women were reported to suffer an increased danger of having a stillborn baby if they drank coffee. Women who drank more than eight cups of coffee a day had a 300 per cent greater risk of stillbirth, compared with those who drank none during pregnancy, according to a report by a Danish university.

Ice cubes
Even ice cubes could not avoid the wrath of the health inspectors. The Health Protection Agency found almost half the ice cubes that it tested in London bars contained bugs found in human faeces, with 5 per cent containing the lethal E.coli

 

http://www.cnn.com/2004/HEALTH/02/06/mercury.reut/index.html

Mercury study shows permanent damage to kids
Saturday, February 7, 2004 Posted: 9:34 AM EST (1434 GMT)

WASHINGTON (Reuters) -- Children whose mothers eat seafood high in mercury while pregnant can suffer irreparable brain damage, new research shows.  The report comes the same week as the Environmental Protection Agency doubled its estimate of how many newborns had unsafe levels of mercury in their blood.
 

http://www.nola.com/news/t-p/index.ssf?/base/news-1/108003396074370.xml


Warning on mercury in tuna criticized

Groups say not enough done to fight pollution

Tuesday March 23, 2004

By Aaron Kuriloff
St. Bernard/Plaquemines bureau

Louisiana sport and commercial fishing associations joined environmentalists Monday in expressing regret about a new federal advisory warning children and pregnant women to avoid eating more than small amounts of canned albacore tuna because of high levels of mercury in the fish.

Albacore contains more mercury than smaller tuna species, such as skipjack or "chunk light" tuna, more commonly sold in cans, said officials with the Food and Drug Administration and the Environmental Protection agency. They also warned young children and women of childbearing age to avoid eating shark, king mackerel and swordfish because of high mercury levels.

Those warnings sound familiar to sport and commercial fishers in a state where health officials have advised residents to avoid regular consumption of fish caught in nearly 30 waterways. But while fishing and environmental groups said federal officials aren't doing enough to combat mercury pollution, commercial fishing organizations said that, for most consumers, the benefits of eating almost all kinds fish far exceed the risks.

"There's nothing new here. Mackerel and tuna have always been hot," said Randy Lanctot, referring to mercury levels in the fish. Lanctot, executive director of the Louisiana Wildlife Federation, an umbrella organization of local hunting and fishing groups said, "It seems like we're going backward and not forward."

Mercury, a heavy metal found in soils and rock, often gets into the food chain through coal-fired power plant emissions, which enter the atmosphere and fall back to earth in rain, ending up in rivers and lakes, state officials and environmentalists said.

Bacteria transform the element into methylmercury, a form toxic to humans, which accumulates in fish. Predator species such as tuna and swordfish contain more mercury than prey such as shrimp or crabs, biologists said.

Because tuna is the second-most-popular seafood in the United States, according to federal statistics, the consequences of mercury contamination remain hotly debated. Health officials say that eating mercury in fish can cause birth defects, nerve and kidney damage, and developmental problems in children younger than 7.

But officials with the U.S. Tuna Foundation, the lobbying group representing Star Kist Foods, Chicken of the Sea International and Bumblebee Seafood -- which has an office in Violet -- pointed to sections of the report emphasizing that heart-friendly omega-3 fatty acids contained in canned tuna promote healthy fetal development, prevent postpartum depression and can reduce the risks of premature births.

"While almost all ocean fish and seafood naturally contain trace levels of mercury, seafood including canned tuna provides a number of heath benefits during pregnancy," Dr. Lillian Beard, an industry spokeswoman and an associate clinical professor of pediatrics at the George Washington University School of Medicine and Health Sciences, said in a written statement.

Sensible consumption will prevent most health risks, said Aaron Viles, Gulf States field organizer for the U.S. Public Interest Research Group. But along with issuing warnings and educating seafood consumers, the federal government should work harder to prevent mercury from reaching the atmosphere, he said.

"Here in Sportsman's Paradise, we have 30 mercury-in-fish advisories and four plants pumping out 1,500 pounds of mercury every year," Viles said. "There are mercury advisories for every single water body running into" Lake Pontchartrain.

But most fish in those waterways aren't particularly vulnerable to mercury contamination, said Ewell Smith, executive director of the Louisiana Seafood Promotion and Marketing Board. While Louisiana anglers do catch tuna and king mackerel in the Gulf, he said, shrimp, crabs and oysters form the backbone of the state's commercial seafood industry, and those species are unlikely to contain high levels of mercury.

Even the game species preferred by local anglers are relatively safe, he said.

"We want people to be safe; that's just good business," he said. "But none of the fish mentioned are really our fisheries. Black drum, redfish, sheepshead and trout are all fish that we have no problems with."

Aaron Kuriloff can be reached at akuriloff@timespicayune.com or (504) 826-3836.
 

http://www.kentucky.com/mld/kentucky/news/nation/12456325.htm

Posted on Tue, Aug. 23, 2005
Monster tuna found to contain high level of mercury

BY TOM AVRIL

Knight Ridder Newspapers

PHILADELPHIA - (KRT) - The monster bluefin tuna that Dan Dillon caught off Delaware was a serious fish - at 873 pounds, more than double the previous state record. But the government says he should go easy with the knife and fork. The mighty fish contained 2.5 parts per million of mercury, the environmental group Oceana reported Tuesday - a level so high it would be illegal to sell.

The U.S. Food and Drug Administration can block the commercial sale of fish containing more than 1 part per million. At levels above 1.9 parts per million, the U.S. Environmental Protection Agency recommends eating less than six meals a year.

Dillon, 39, of Herndon, Va., who caught the tuna July 2 after a 90-minute struggle, split the big fish among family and friends. Delaware officials urged him to proceed cautiously, and Dillon said Tuesday that he heeded the advice. "I haven't really eaten that much myself," said Dillon, who donated a 5-ounce sample to Oceana, based in Washington, D.C., for testing. "We spread it around."

Rick Greene, head of the water toxics program for the Delaware Department of Natural Resources and Environmental Control, said he expected the mercury level to be high. Tuna are large fish at the top of the food chain, accumulating mercury from the smaller fish they eat, and this tuna was far larger and likely far older than most, he noted. "Quite frankly, I'm not surprised by this result," said Greene, who is conducting his own mercury tests on the fish.

The mercury level in Dillon's fish is not the highest reported; Japanese researchers have found bluefin with more than 6 parts per million of mercury. Canned tuna has much lower levels of mercury, but health experts urge pregnant women and small children to limit consumption of that product, too. Scientists believe mercury can harm fetal brain development.

Bert Adams, owner of the shop where the big fish was carved into 500 pounds of steaks, said his customers didn't seem too concerned.

"They want their tuna fish cleaned."

But when Dillon threw a giant tuna party, the pregnant woman there wasn't biting.
 

Sobering estimate from EPA that 630,000 babies are born with mercury exposure
that could affect intelligence...

For pregnant moms, low-mercury fish is intelligent choice
By Jim McQuiggin
In a newly released Harvard study, doctors have concluded that women who eat fish at least twice a week can boost the intelligence of their newborn. The study, conducted among 135 Boston-area women, showed that women who ate fish at least twice a week during the second trimester had babies with the highest intelligence scores. It is important to note that the fish consumed among the mothers in the test had mercury levels below 1.2 parts per million.

Although nearly all fish contain trace amounts of mercury but larger species such as swordfish, shark, and albacore tuna accumulate the highest levels. In fact, the US Food and Drug Administration entirely rules out those species, as well as mackerel and tilefish taken off the Atlantic Coast and Gulf of Mexico, for pregnant and nursing women and young children. Some white and albacore tuna, canned and fresh, also have high mercury levels. Generally, the darker the fish meat, the higher the mercury content. About 630,000 babies a year are born with mercury exposure that could reduce their mental abilities, the U.S. Environmental Protection Agency estimates.

For each additional weekly serving of fish, the babies' intelligence scores increased by 4 points, or an average of almost 7%. But for every increase of 1 part per million of mercury, the babies' intelligence scores dropped by 7.5 points, or 12.5%. A woman could raise her mercury level by 1 ppm if she ate an average-sized serving of swordfish once a week, said Dr. Emily Oken of Harvard Medical School, the study's lead researcher. In tests designed by neuropsychologists to study early signs of intelligence and memory, the Boston-area babies were shown photographs of new faces and ones they had been shown before, and the researchers recorded how much time they spent studying each one. Babies score higher on the test if they move quickly from the familiar face, indicating recognition, to exploring the new face.
 

On call: Tuna on white; hold the mercury
 By Dana Whitten
BELFAST (Feb 21): Parents of youngsters exploring solid foods sometimes ask if fish, particularly tuna fish, is safe for them. Most of us are aware that there is a concern about mercury contamination with harmful side effects in many species of fish; remember when swordfish was unavailable because of mercury? This article will briefly survey what is known of the environmental dangers of mercury, particularly how it is related to us in Maine, a state in which mercury levels in fish, loons and eagles are among the highest in the country.   Mercury is an environmental toxin, found everywhere, that causes a wide range of adverse health effects in humans. Three forms of mercury (elemental, inorganic and organic) exist, each with its own type of toxicity. Exposure to this heavy metal occurs after inhalation or ingestion, and everyone is exposed to at least small amounts. It occurs naturally in ore and fossil fuels such as coal and petroleum. Environmental contamination
results from the actions of man, mining, smelting and industrial discharges.   Elemental mercury or quicksilver is that funny silvery, beady substance we were entranced with as kids, rolling it around in our palms after a thermometer broke. (If you ever see a kid playing with liquid mercury, intervene and find out from a toxicology expert how to safely dispose of the substance; poisoning can occur from inhaling invisible vapors.)   It is the liquid form of the metal and was once used in other medical instruments and is now used in dental fillings, fluorescent light bulbs and button batteries.

Indiscriminate disposal of these items in landfills or waste incinerators is a major source of environmental contamination as the substance readily vaporizes, is inhaled and passes from the lungs to the red blood cells and deposits in the brain, spinal cord and kidneys. It easily crosses the placenta and accumulates in the fetus.   Elemental mercury can cause acute, life-threatening illness and chronic brain disease such as occurred with hat makers who used liquid mercury in processing felt hats. (Hence the "Mad Hatter" from "Alice in Wonderland.") It is presently believed that dental fillings do not pose a threat as elemental mercury is poorly absorbed from the gut. We didn't worry too much when a child bit off the end of a thermometer and swallowed some.   Inorganic mercury compounds (salts) have long been used for their antibacterial properties. They were also used a century ago in teething powders, all of these being long-banned from use in this country. Ingestion can be very toxic and was a not-uncommon form of suicide. A long forgotten childhood illness, pink disease, was seen in infants exposed to teething powders and organic mercury compounds in latex paint and diaper fungicides. Inorganic mercury compounds are still available on the world market.   Organic mercury compounds, primarily methyl mercury and ethyl mercury, have been produced as biocides and pesticides and were once found in two common household antiseptics: mercurochrome and merthiolate. Methyl mercury is a predominant form of mercury in our environment and is formed by microorganisms from elemental mercury dropped out of the air in precipitation, originating mainly from incineration and discarded household products evaporating into the atmosphere. It is estimated that 650 tons of mercury escape into the environment and are formed in microorganisms each year. Methyl mercury produced by microorganisms when atmospheric mercury hits water is ingested by small fish and shellfish and bioaccumulates up the food chain as larger fish eat smaller ones.   Methyl mercury is a permanent resident in these small animals and others that eat them (loons, eagles, sharks, whales, humans) and cannot be removed by processing. It is slowly excreted as consumption levels continue to rise. There is an alarming rate of death in loons in Maine due to methyl mercury; fatality rates in other animals are unknown.   Methyl mercury is 95 percent absorbed by the bowel in man and passes through the placenta, into the brain and breast milk. It is most toxic to the developing brain of the fetus, causing destruction of certain cell types; after birth, retardation, blindness, deafness and seizures may develop. There have been two large human-produced disasters, in Mina Mata Bay, Japan and in Iraq.
 
While most of the mothers were mainly unaffected, unborn children were severely affected.   Interestingly, already born, exposed children had a good capacity to recover from neurological involvement. Their symptoms included behavior changes and learning problems. There are two ongoing large studies in the world regarding the development of children in saltwater fish-eating populations. In older children and adults, larger amounts of mercury ingested from eating fish are required to produce symptoms; these include tingling, prickling or numbness of the hands and feet, or visual changes.   All fish in Maine lakes, ponds and rivers have methyl mercury in them. We receive the industrial waste that blows west to east across the country, bringing to coastal states our increased rates of asthma and mercury exposure. Fish-eating fish, such as pickerel and bass, and older fish have the highest levels. Brook trout and landlocked salmon are the safest.   "Safe Eating Guidelines" produced by the Bureau of Health states that pregnant and nursing women, women who may get pregnant, and children under 8 should not eat freshwater fish, and one meal per week of the trout and salmon is safe. That is pretty sad, as fish is a nutritious, low-fat and otherwise healthy food. Other contaminants such as PCBs, dioxins or DDT are found at high levels in certain freshwater bodies preventing any safe eating of any fish. In this part of Maine that includes the Kennebec River from Augusta to the Chops.   As for saltwater fish, the guidelines say no swordfish, shark or tilefish or king mackerel for pregnant or nursing women, women who may become pregnant, or children under 8. The same group should only eat one can of "white" (albacore) or  two cans of light tuna per week.

Consumption of striped bass and bluefish should be limited to two meals per month for everyone. Lobster tomalley is high in environmental contaminants and should not be eaten by anyone.   Lastly, I need to mention that ethyl mercury in the form of thimerosal was used in routine childhood immunizations prior to 1999. Less is known of the toxic effects of ethyl mercury than methyl mercury, but the FDA questioned whether infants receiving thimerosal-containing vaccines might be exposed to higher-than-acceptable levels of mercury. Studies have not been completed, but so far there is no consensus that this form of mercury in the doses used caused neurotoxicity that is detectable. Based on a joint recommendation by the American Academy of Pediatrics and the U.S. Public Health Service, none of the routine childhood vaccines contain thimerosal. Phenyl mercury was removed from interior latex paints in 1991.   Mercury in all forms is toxic to fetuses and children. There is no effective method of treating mercury poisoning, so prevention is essential. In our state, where fishing is a popular pastime and an important form of livelihood, all of us who are consumers and providers of this generally healthy food need to be aware and up to date on the safety issues of what goes on our plates. Pass the lemons, please!
 Dr. Dana Whitten practices at Belfast Pediatrics.  


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