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Abelsohn A.,University of Toronto | Vanderlinden L.D.,Healthy Environmental | Vanderlinden L.D.,Lana | Scott F.,Lana | And 2 more authors.
Canadian Family Physician | Year: 2011

Objective: To provide family physicians with a practical, evidence-based approach to counseling women about healthy fish eating. Sources of information: MEDLINE was searched for articles published between 1999 and 2008. Most studies described in this article provide level II or III evidence. Main message: Fish is an important component of a healthy diet for women in their reproductive years owing to the beneficial effects of omega-3 fatty acids on the neurologic development of the fetus. However, some fish species contain considerable methylmercury, which crosses the placenta and has harmful effects on neurobehavioural development. As many jurisdictions have issued fish consumption advisories, which can be confusing, women would benefit from individualized assistance from a trusted source, their family physicians, to clarify the risks and benefits of eating fish. Conclusion: We recommend that family physicians counsel women in their reproductive years about healthy choices regarding fish in their diet, and provide appropriate resources.

Kershaw S.,Ryerson University | Gower S.,Healthy Public Policy Directorate | Gower S.,University of Toronto | Rinner C.,Ryerson University | And 2 more authors.
Geospatial Health | Year: 2013

Numerous environmental justice studies have confirmed a relationship between population characteristics such as low-income or minority status and the location of environmental health hazards. However, studies of the health risks from exposure to harmful substances often do not consider their toxicological characteristics. We used two different methods, the unit-hazard and the distance-based approach, to evaluate demographic and socio-economic characteristics of the population residing near industrial facilities in the City of Toronto, Canada. In addition to the mass of air emissions obtained from the national pollutant release inventory (NPRI), we also considered their toxicity using toxic equivalency potential (TEP) scores. Results from the unit-hazard approach indicate no significant difference in the proportion of low-income individuals living in host versus non-host census tracts (t(107) = 0.3, P = 0.735). However, using the distance-based approach, the proportion of low-income individuals was significantly higher (+5.1%, t(522) = 6.0, P <0.001) in host tracts, while the indicator for "racialized" communities ("visible minority") was 16.1% greater (t(521) = 7.2, P <0.001) within 2 km of a NPRI facility. When the most toxic facilities by non-carcinogenic TEP score were selected, the rate of visible minorities living near the most toxic NPRI facilities was significantly higher (+12.9%, t(352) = 3.5, P = 0.001) than near all other NPRI facilities. TEP scores were also used to identify areas in Toronto that face a double burden of poverty and air toxics exposure in order to prioritise pollution prevention.

Mah C.L.,University of Toronto | Mah C.L.,Food Policy Research Initiative | Vanderlinden L.,University of Toronto | Mamatis D.,Healthy Public Policy Directorate | And 3 more authors.
Canadian Journal of Public Health | Year: 2013

OBJECTIVES: The purpose of this research was to assess key stakeholder attitudes regarding menu labelling in Toronto, the largest municipality in Canada. Menu labelling is a population health intervention where food-labelling principles are applied to the eating-out environment through disclosure of nutrient content of food items on restaurant menus at the point of sale. Menu-labelling legislation has been implemented in the United States, but has yet to be adopted in Canada. As provincial voluntary programs and federal analyses progress, municipal jurisdictions will need to assess the feasibility of moving forward with parallel interventions. METHODS: Data were collected and analyzed in late 2011 to early 2012, including: a consumer eating-out module incorporated into a public health surveillance telephone survey (n=1,699); an online survey of independent restaurant operators (n=256); in-depth key informant interviews with executives and decision makers at chain restaurants (n=9); and a policy consultation with local restaurant associations. RESULTS: Toronto residents, particularly men, younger adults, and those with higher income or education, frequently eat out. A majority indicated that nutrition information is important to them; 69% note that they currently use it and 78% reported they would use it if it were readily available. Resistance to menu-labelling requirements at the municipal level was articulated by franchise/chain restaurant executives and industry associations. Despite overall low interest among independent restaurant operators, 57% reported feeling some responsibility to provide nutrition information and 50% believed it could be good for business. CONCLUSIONS: This research supports earlier literature that indicates strong public support for menu labelling alongside perceived barriers among the restaurant and foodservices sector. Leverage points for effective operator engagement for menu-labelling adoption were identified, nonetheless, highlighting the need for public health support.

Hau M.,Toronto Public Health | Hau M.,University of Toronto | Cole D.,University of Toronto | Vanderlinden L.,University of Toronto | And 4 more authors.
International Journal of Occupational and Environmental Health | Year: 2014

Purpose: The precautionary principle (PP) urges actions to prevent harm even in the face of scientific uncertainty. Members of Toronto Public Health (TPH) sought guidance on applying precaution. Methods: We searched five bibliographic databases (yield 60 articles from 1996 to 2009 and 8 from 2009 to 2011) and Google (yield 11 gray literature sources) for material relevant to local public health. From these sources, we extracted questions until saturation was reached (n555). We applied these questions retrospectively to eight case studies where TPH felt precaution was applied. We ranked questions for their importance in applying precaution. Results: Our final guide included 35 questions in five domains: context, assessment, alternative interventions, implementation, and monitoring and evaluation. Importance rankings varied across cases, but the role of stakeholders in driving precautionary action was consistent. Monitoring and evaluation components could have been strengthened across cases. Conclusion: The TPH guide can assist municipal environmental health practitioners in applying precaution in a more transparent manner. © W. S. Maney & Son Ltd 2014.

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