Feature Stories


By: Deborah Fleischer, Green Impact, March 2021


Teach Your Patients to Be Fish Smart

As reported in the San Francisco Chronicle, the coronavirus pandemic is prompting more people to get outdoors, which has spurred an increase in fishing, either for recreation or to supplement the protein in their meals. With the abundance of shorelines around the Bay Area, it is a common sight to see people lined up and down the piers fishing, in search of halibut, perch, and striped bass. There’s a ‘catch,’ though: pollutants in the Bay mean not all fish are created equal.

With all of the national headlines these days, you might have missed the news about the recent oil spill off Richmond. In early February, the Chevron refinery spilled an estimated 600 gallons of a mixture of oil and gasoline into San Francisco Bay, setting off alarms about potential health impacts to the residents of Richmond, already burdened with a high pollution load.

According to CalEnviroScreen 3.0, the area around the Richmond refinery is extremely burdened by pollution and toxic releases. According to the Executive Director of San Francisco Bay Keeper, “The people of Richmond already carry a disproportionate environmental burden, and spills like this add life-threatening exposure to toxic pollutants.” Refinery pollution contributes to high rates of asthma, cancer, and heart disease among the predominantly Black, Latino, Asian, and Pacific Islander residents in Richmond.

The spill serves as a reminder of the environmental justice issues that exist in the Bay Area—and of the pollution and contamination that the Bay contains. Unfortunately, this means that eating too many fish from the Bay can be hazardous for people who might rely on it as a food source, which are often the same groups of people who are disproportionately impacted by other toxic pollutants like residents in Richmond.

Advice for UCSF Healthcare Clinicians

UCSF healthcare providers may have patients who consume large amounts of fish and need to be educated about which fish are best to eat regularly, especially those from disadvantaged communities that might live near higher levels of pollution. Dr. Mark Miller, Co-Director, Western States Pediatric Environmental Health Specialty Unit at UCSF, explained, “All healthcare providers should ask if a family is eating sport fish from the Bay.”

If they are, he continued, “Clinicians should advise patients to follow the fish consumption guidance from the Office of Environmental Health Hazard Assessment (OEHHA). Overall, fish are a healthy food for women, the fetus, and children, but certain fish have higher levels of contaminants like mercury and PCBs.”

The OEHHA has issued a fish consumption advisory for fish taken from the San Francisco Bay. The guidelines provide information that anglers and their families can use to protect themselves from harmful health effects that could result from eating large amounts of fish with high levels of mercury or PCBs (polychlorinated biphenyls). Mercury can harm the brain and nervous system of babies and children, affecting behavior and learning ability as they grow. PCBs have the potential to cause cancer, serious effects on the immune system, and neurological and reproductive impacts.

According to OEHHA, because fetuses and children are particularly sensitive to the effects of these chemicals, women of childbearing age and children 17 years and younger should be especially careful to follow the specific guidelines provided for them. A second set of guidelines is provided for men and women beyond childbearing age to protect their health. The guidelines can be found here in multiple languages, including Chinese, Japanese, Laotian, Vietnamese, and Spanish).

OEHHA recommends that women of childbearing age and children not eat:

  • Striped Bass
  • Sharks
  • White sturgeon
  • Surfperches

Eat the Right Fish

The take-home message to patients: “Eat fish. But make sure to eat the right fish.” The OEHHA guidelines recommend safer fish that can be eaten for one or two servings per week.

Fish infographic
Image Source: California Office of Environmental Health Hazard Assessment

The Environmental Working Group stresses, “Children born to mothers who eat fish and shellfish that are rich in omega-3 fatty acids and low in mercury during pregnancy have better cognition and behavior than children born to mothers who skip fish altogether, according to some scientific tests.”

Here are two additional resources to guide you in making safer and healthier seafood choices—for yourself, your family, and the environment: