COHP replies

The recommendations in the HealthLink BC files have been developed based on BC and Canadian evidence and data indicating safe and at-risk human body mercury levels and consumption levels. The BC Centre for Disease Control (BCCDC) and the Ministry of Health Services (MOHS) agree with Health Canada’s review of mercury toxicity levels and the guidelines limiting mercury to below 1.0 ppm and 0.5 ppm for most fish and shellfish species sold in Canada. But because BC fish consumption patterns are unique in Canada and there is regional variation in mercury levels in the fish available to consumers across Canada, Health Canada’s fish consumption guidelines regarding mercury risk do not apply well in the BC context. For British Columbians, information on local patterns of fish consumption, local levels of mercury in different fish species, and local risk factors for elevated blood mercury were carefully considered.

In addition, the BCCDC and the MOHS categorized the mercury level in different fish species into low (<0.1 ppm), moderate (between 0.1 ppm and 0.5 ppm), and high (>0.5 ppm) making them easier to understand. Health Canada has one regulatory cut point of 0.5 ppm of mercury and has recom­mended consumption limits for fresh and frozen tuna and canned albacore. Health Canada states that canned albacore tuna has higher mercury levels than other types of canned tuna and therefore does not recommend limits for consuming other types of tuna. The BCCDC and MOHS support grouping all canned tuna, including albacore, into the moderate category.

The types of recommendations can be confusing, especially between the different canned tuna, and fresh and frozen. Since the BCCDC and the MOHS have focused on local fish and local risk factors, their recommendations may be more appropriate.

—Shefali Raja, BSc, RD
Nutrition Committee, Council on Health Promotion

Shefali Raja, BSc,. COHP replies. BCMJ, Vol. 51, No. 6, July, August, 2009, Page(s) 239 - Letters.

Above is the information needed to cite this article in your paper or presentation. The International Committee of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

About the ICMJE and citation styles

The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.

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For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit

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