BACKGROUND Health risks linked with dioxin in fish remain a complex policy issue. Fatty Baltic fish contain persistent pollutants, but they are otherwise healthy food. We studied the health benefits and risks associated with Baltic herring and salmon in four countries to identify critical uncertainties and to facilitate an evidence-based discussion. METHODS We performed an online survey investigating consumers' fish consumption and its motivation in Denmark, Estonia, Finland, and Sweden. Dioxin and methylmercury concentrations were estimated based on Finnish studies. Exposure-response functions for several health endpoints were evaluated and quantified based on the scientific literature. We also quantified the infertility risk of men based on a recent European risk assessment estimating childhood dioxin exposure and its effect on sperm concentration later in life. RESULTS Baltic herring and salmon contain omega-3 fatty acids and vitamin D, and the beneficial impact of these fishes on cardiovascular diseases, mortality, and the risk of depression and cancer clearly outweighs risks of dioxins and methylmercury in people older than 45 years of age and in young men. Young women may expose their children to pollutants during pregnancy and breast feeding. This study suggests that even in this critical subgroup, the risks are small and the health benefits are greater than or at least similar to the health risks. Value of information analysis demonstrated that the remaining scientific uncertainties are not large. In contrast, there are several critical uncertainties that are inherently value judgements, such as whether exceeding the tolerable weekly intake is an adverse outcome as such; and whether or not subgroup-specific restrictions are problematic. CONCLUSIONS The potential health risks attributable to dioxins in Baltic fish have more than halved in the past 10 years. The new risk assessment issued by the European Food Safety Authority clearly increases the fraction of the population exceeding the tolerable dioxin intake, but nonetheless, quantitative estimates of net health impacts change only marginally. Increased use of small herring (which have less pollutants) is a no-regret option. A more relevant value-based policy discussion rather than research is needed to clarify official recommendations related to dioxins in fish.

中文翻译：

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波罗的海鲱鱼和鲑鱼中营养物质和环境污染物对健康的影响：定量风险评估。

背景技术与鱼类中二恶英有关的健康风险仍然是一个复杂的政策问题。高脂波罗的海鱼类含有持久性污染物，但它们还是健康食品。我们研究了四个国家与波罗的海鲱鱼和鲑鱼相关的健康益处和风险，以识别关键的不确定性并促进循证讨论。方法我们在丹麦，爱沙尼亚，芬兰和瑞典进行了一项在线调查，调查消费者的鱼类消费及其动机。根据芬兰的研究估算了二恶英和甲基汞的浓度。根据科学文献评估和量化了多个健康终点的暴露反应功能。我们还根据一项最近的欧洲风险评估对男性的不孕风险进行了量化，该风险评估估计了儿童二恶英的暴露及其对生命后期精子浓度的影响。结果波罗的海鲱鱼和鲑鱼含有omega-3脂肪酸和维生素D，这些鱼对心血管疾病，死亡率以及患抑郁症和癌症的风险明显大于45岁以上人群中二恶英和甲基汞的风险和年轻人。年轻妇女在怀孕和哺乳期间可能使孩子暴露于污染物中。这项研究表明，即使在这个关键的亚组中，风险也很小，健康收益大于或至少类似于健康风险。信息分析的价值表明，剩余的科学不确定性不大。相反，存在一些本质上是价值判断的关键不确定性，例如，超出每周可忍受的摄入量是否是不利的结果；以及特定于小组的限制是否有问题。结论在过去的10年中，波罗的海鱼类中二恶英引起的潜在健康风险降低了一半以上。欧洲食品安全局发布的新风险评估明显增加了超过二恶英摄入量的人口比例，但是，对健康净影响的定量估计仅发生了微小变化。增加对小鲱鱼的使用（污染物少）是无悔的选择。为了阐明与鱼类中二恶英有关的官方建议，需要进行更多基于价值的政策讨论而不是研究。