Risk-Benefit Modeling to Guide Health Research in Collaboration with Great Lakes Fish Consuming Native American Communities.

It is well documented that fish consumption imparts both health risks and benefits. Furthermore, fish harvest and consumption are an essential part of Great Lakes Native American cultures. Quantitative models that compare risk and benefits to potential consumption scenarios can help guide future health research as well as consumption advice for potentially sensitive populations. This article presents fish consumption scenarios based on self-reported meal plans constructed by tribal members in eastern upper peninsula and northern lower Michigan Anishinaabe. Two risk-benefit models were applied to these scenarios to estimate the potential neurodevelopmental and cardiovascular risks (either increased or reduced risk) from dioxin-like polychlorinated biphenyls (DL-PCBs), methylmercury (MeHg), and omega-3 polyunsaturated fatty acids (n3-PUFA). All scenarios except maximum exposure estimates (i.e. 25th-75th percentile MeHg, DL-PCB, and n3-PUFA intakes) predicted reduced cardiovascular risk and improved neurodevelopmental outcomes. The greatest predicted benefits (adjusted for risks) occurred at the 75th percentile intake of MeHg, DL-PCB, and n3-PUFA scenarios: 5.0 visual recall memory (VRM) and 4.41 Intelligence Quotient (IQ) benefits, and 28% reduced risk of cardio-vascular disease. Scenarios based on maximum self-reported intake, however, predicted health detriments. These results suggest that most fish consumption scenarios as constructed in collaboration with Native American communities could impart health benefits despite the presence of contaminants. However, high-end consumption estimates warrant caution as well as the need for well-crafted advice. Potential benefits further underscore the value of reducing contamination burdens in Great Lakes fisheries. Future priorities of ongoing contamination monitoring and health research are discussed.