Sentinel Human Health Indicators: A Model for Assessing Human Health Status of Vulnerable Communities

The presence of toxic substances in the Great Lakes (GL) continues to be a significant concern. Eleven of the most persistent and ubiquitous substances were identified as “critical Great Lakes pollutants” by the International Joint Commission (IJC). In some areas of the GL these toxic substances bioaccumulate in sediment and organisms, biomagnify in food webs, and persist at high levels. The Agency for Toxic Substances and Disease Registry (ATSDR) Great Lakes Human Health Effects Research Program (GLHHERP) characterizes contaminant exposures via GL fish consumption and investigates the potential for short- and long-term adverse health effects. The program has identified a set of eight indicators to determine risk. The GLHHERP findings indicate: (1) vulnerable populations are still being exposed to persistent toxic substances (2) body burden levels are two to four times higher than in the general U.S. population, (3) women and minorities are less knowledgeable about fish advisories than other segments of the population, (4) the presence of neurodevelopmental deficits in newborns, and cognitive deficits in children and adults, and (5) disturbances in reproductive parameters have been demonstrated in adults. The public health implications of these findings and the need for intervention strategies are discussed.