EPA g-IO/R-99-003
             United States
             Envi'onmentai Protection
             Agency
Region 10
1200 Sixth Avenue
Seattle WA 98101
Alaska
Idaho
Oregon
Washington
             Office of Environmental Assessment  Risk Evaluation Unit
               May 1999
             Asian & Pacific Islander
             Seafood Consumption
             Study in King County, WA

             Exposure Information Obtained through a Community-
             Centered Approach
             Study Results and Education Outreach



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     Asian and Pacific Islander Seafood Consumption Study
   Ruth Sechena, MD, MPH1, Connie Nakano, BA, Shiquan Liao, Ph.D., Nayak
      Polissar, Ph.D., Roseanne Lorenzana, DVM, Ph.D., Simon Truong, and
                       Richard Fenske, Ph.D., MPH
                             May 27,1999
                              Funded by:

              EPA Environmental Justice Community/University
               Partnership Grant EQ925003-01
                  Project Officer: Susan Morales
                  EPA 910/R-99-003 (Phase II)
                  EPA 910/R-96-007 (Phase I)
Address correspondence to:

'Ruth Sechena, MD, MPH
Director, NIEHS Center Community Outreach Programs
4225 Roosevelt Way NE, #100
Seattle, Washington 98105
e-mail: rsechena@u.washington.edu

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 Address correspondence to:
 Connie Nakano, BA
 University of Washington
 Box 356429
 Seattle, WA 98195

 Shiquan Liao, Ph.D.
 StatPro Consultants
 7127 NE167"1 Street
 Bothell, WA98011

 Nayak Lincoln Polissar, Ph.D.
 The Mountain-Whisper-Light
 Statistical Consulting
 1827 23rd Avenue, East
 Seattle, WA 98112-2913

 Roseanne Lorenzana, DVM, Ph.D., DABT
 U.S. EPA—Region 10
 1200 Sixth Avenue
 Seattle, WA 98101

 Simon Truong
 Social Services Director
 The Refugee Federation Service Center
 7101 Martin Luther King, Jr. Way S., #214
 Seattle, WA 98118

 Richard Fenske, PhD, MPH
 Department of Environmental Health
 University of Washington
Box 357234
Seattle, WA 98195

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                            Table of Contents


 Executive Summary	',	1
 I.  Introduction	4
 II. Background	6
 III. Implementation of the Study (Phase II)	9
      A.  Methodology	9
          1. Overview	9
      B.  Community Support, Study Design, Questionnaire
          Development	9
          1. Committee Guidance	10
          2. Development of Survey Instruments	11
            a. Survey Questionnaire	11
            b. Visual Aids	11
            c. Determination of seafood model weights	12
      C.  Survey Implementation and Data Analysis (Phase II)	.14
          1. Interviewer Recruitment, Training, and Quality
            Assurance	14
            a. Interviewer Recruitment	14
            b. Training and Quality Assurance	14
          2. Questionnaire Pilot Testing	15
          3. Sampling Strategy.	15
            a. Respondent Selection Criteria	15
            b. Ethnic Representation	15
         4. Subject Recruitment	16
            a. Roster recruitment	17
            b. Volunteer recruitment	18
         5. Questionnaire Administration	'_	19
            a. Re-interviews	20
            b. Questionnaire editing	20
            c.  Double Key Data Entry	20
         6. Data Analysis	21
            a. Statistical Methods	21
IV. Survey Results (Phase II)	25
      A. Participation Rate	25
      B. Descriptive Statistics	25
      C. Seafood Consumption Rates	27
         1. Consumption rate for the API community	27
         2. Consumption rate by ethnicity	29
         3. Consumption rate by gender	30
         4. Consumption rate by age	31
         5. Consumption rate by income	31
         6. Consumption rate by educational level	32
         7. Consumption rate by roster category
           and volunteer category	32
         8. Consumption rate by fishermen and
           non-fishermen	33
         9. Consumption rate by generation	34
      D. Fish Sources	35
      E. Seafood Species and Parts Consumed	36
         1. Seafood species consumed	36

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                           Table of Contents


         2. Seafood parts consumed	37
      F.  Preparation Methods	38
      G. Re-interviews	40
      H. Educational Outreach Information	.41
V. Education and Communication of Study Findings (Phase III)	44
      A. Methods	44
         1. Introduction	44
         2. Selection of an Education/Communication Tool	44
         3. Development of Education/Communication Tool	45
         4. Translation and Focus Group Testing            	46
VI. Results (Phase III)	47
Discussion	;.47
      Participation Rates	47
      Potential Biases	48
      Per Capita Consumption Habits	50
      Consumption Rates.	51
      Seafood Sources	53
      Seafood Species and Tissue Parts Consumed	53
      Fishermen   	55
      Educational Outreach information	56
Conclusions	57
Acknowledgments	•	58
References	62

Appendix A:    Questionnaire	65
Appendix B-l:   Picture of models	85
Appendix B-2:   Table of Models and Model Weights Used	86
Appendix B-3:   Calculation of edible meat percentage
               for models A, B, D, and P                              87
               Table B-3-a (Model A)                                 87
               Table B-3-b (Model B)                                 88
               Table B-3-c (Model D).                                 88
               Table B-3-d (Model P)	;	.89
Appendix C:    Species Manual	90
Appendix D:    Interviewer Telephone Script	.97
Appendix E:    Record of Contacts.	100
Appendix F:    Letter to roster organizations, Governor Locke's
               letter of support for study, and Agreement
               of Consent	102
Appendix G:    Letter of Introduction to study participants,
               and postcards—English, and translations	106
Appendix H:    Posters—English and  translations.	Ill
Appendix I:     Consent for future contact	123
Appendix J:     Re-interview data and script	125
Appendix K:    Types of Seafood Consumed/Respondents
               Who Consume (%)	129
Appendix L:    Outlier Table	131

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                              Table of Contents
Appendix M-l-a. Participation Rates by Participant
                Category	 134
        M-l-b.  Miscellaneous Seafood Consumers 	 135
        M-2-a.  Demographic & Seafood Preparation
                characteristics: "higher" & "lower" 	 136
        M-2-b.  Demographic & Seafood Preparation
                characteristics: "higher" & "lower" 	 137
        M-3    Seafood consumption rates by ethnicity	 138
        M-4    Seafood consumption by ethnicity and gender  	 140
        M-5.    Seafood consumption by age	 143
        M-6.    Seafood consumption by income	 144
        M-7.    Seafood consumption by education 	 145
        M-8.    Seafood consumption roster versus volunteer  	 146
        M-9.    Seafood source by ethnicity	 147
        M-10.   Comparison between original survey and
                re-interview responses on selected questions	 149

Appendix N:     Phase III
        N-l.    CSC ranking of seafood health concerns  	 151
        N-2.    Draft brochure	 152
        N-3.    Focus group Evaluation Questionnaire	 155
        N-4.    Focus analysis of brochure	 157
        N-5.    Reviewers comments of translation f the brochure	158
        N-6.    Revised brochure with incorporated comments  	 169

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                             List of Tables
 Table M-l:  Sample Size based on Population Proportionate Sampling Versus
            Actual Sample Size based on Community Steering Committee's
            Recommendation	16
 Table R-l:   Consumption Rate of API Community Members	28
 Table R-2:   Consumption Rate by Gender for All Asian and Pacific
            Islander Community.	31
 Table R-3:   Consumption Rates by Roster and Volunteer	33
 Table R-4:   Consumption Rates by "Fishermen"
            and "Non-fishermen"	34
 Table R-5:   Generation by Income	34
 Table R-6:   Seafood Consumption by Generation                        35
 Table R-7:   Fish Sources	!Z!!!!!."Z"ZZ"Z.""!"!"!"™"!!36
 Table R-8:   Parts of Finfish Consumed by Ethnicity.	37
 Table R-9:   Shellfish Consumption (Bivalves)	~"!!Z!!!!!Z!!!!!!!!!!!!!!!"!"Z!!38
 Table R-10:  Non-Bivalve Shellfish Consumption"l"ZZZ.!"...!	"!!!!!!Z..Z~38
 Table R-l 1:  Fish Preparation Methods.         	         	39
 Table R-12:  Seafood Cooking Water Usage	
            (Percentage of Time Used)	39
 Table R-13:  Comparison of Answers between Original Survey and Re-
            Interview	41
Table R-14:  Best/Most Reliable Sourcesi of Information Used by the API
            Community	_                           42
Table R-15:  Preferred Learning Methods                                42
Table R-16:  Preferred Seafood Information	43
Table R-17:  Fishing Safety Information Sources for
            All Fishermen by Education	43

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                        EXECUTIVE SUMMARY

 PURPOSE

 The primary purpose of this study was to describe Asian and Pacific Islander
 (API) seafood consumption rates, species, and seafood parts commonly
 consumed and cooking methods. This information is needed to allow the
 API community in the Pacific Northwest to determine what risks it may face
 from seafood and to balance  such risks with the significant health and
 cultural benefits associated with seafood consumption. This study was a first
 step towards gathering necessary information for such a risk assessment.
 Study aims also included development of culturally appropriate health
 messages related to seafood consumption and the field testing of this
 information within the API  community.

 METHODS

 This work was made possible only because of the willingness of API
 community leaders and the Refugee Federation Service Center to work in
 partnership with the University of Washington—National Institute for
 Environmental Health Sciences (UW-NIEHS) Center  for Ecogenetics and
 Environmental Health, Community Outreach and Education Program.

 Description and quantification of seafood consumption habits with the API
 community was conducted in three phases.  Phase I was considered a
 planning phase, and focused  on identifvinft-*afpet-ethnic_ groups and
 developing an appropriate questionnaire. This work was accomplished prior
 to the inltTatiorToTthe study reported here and was published as a U.S. EPA
 Report (Asian and  Pacific Islander Seafood Consumption Study, EPA 910/R-
 96-007, August 1996).

 Phase II, which is detailed in this report, focused on the characterization of
 seafood consumption patterns of ten API ethnic groups (Cambodian, Chinese,
 Filipino,  Hmong, Japanese, Korean, Laotian, Mien, Samoan, and Vietnamese)
within King County, Washington. Participants were first or second
generation members of the above ethnic groups, 18 years of age or older, who

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 lived in King County, Washington, and were seafood consumers. Data were
 collected using a survey questionnaire that was developed in English and
 later translated into the Respondents' native languages.  The surveys were
 administered by trained bilingual interviewers recruited fromjhe API__
 community.  The questionnaire solicited information about the types of
 seafood consumed, the source of the seafood, the preparation of seafood, the
 frequency and portion size of consumption by the  respondents, demographic
 information,  and educational approaches preferred by the respondents. Two
 hundred participants were sought, and two selection methods were used.
 First, volunteers were recruited for a "Dietary Habits Study" and from those
 volunteers participants were randomly selected.  Second, religious and API
 community organizations donated membership  rosters from which potential
 participants were randomly selected and contacted.

 Phase III, also detailed within this report,  focused on the development of
 culturally appropriate health messages related to seafood consumption risks
 and the dissemination of this information to the API community.  The
 technical expertise of the Advisory and Technical Committees was linked to
 the cultural expertise of the Community Steering Committee to develop an
 appropriate health education strategy. These efforts culminated in a multi-
 lingual  brochure that highlighted five key public health messages.  The
 brochure was then tested through an API focus group.

 RESULTS

 The majority  of the 202 respondents (89%) were first generation (i.e., born
 outside  the United States). There were slightly more  women (53%) than men
 (47%), and 35% lived under the 1997 Federal Poverty  Line.  In general, the API
 members consumed seafood at a very high rate. The  average overall
 consumption  rate for all seafood combined was 1.891  grams/per kilogram
body weight/day (g/kg/day), with a median consumption rate of 1.439
g/kg/day. The predominant seafood consumed was shellfish (46% of all
seafood).  Seafood consumption based on gender, age, income, and
"fishermen" status did not differ significantly.
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 First generation APIs consumed more fish than the second generation APIs_
 in all the fish categories, except pelagic fish - the consumption rates being
 statistically different for freshwater fish and shellfish.  In general, members of
 the  Vietnamese and Japanese communities had the highest overall
 consumption rates of all seafood; and the Mien, Hmong, and Samoan
 communities consumed the least amount of seafood.

 The proportion seafood harvested (rather than purchased commercially) by
 API community members varied from a low of 3% to a high of 21%,
 depending on the seafood type. Differences were observed among the. ethnic
 groups, with Japanese, Chinese, Filipino, and Korean groups consuming
 more seafood that was purchased commercially.  Members of the Mien,
 Hmong, and Laotian communities seemed to harvest seafood more often
 than other ethnic groups. Salmon, tuna, shrimp, crab, and squid were the
 most frequently consumed seafood.  Skin was consumed with fillets 55% of
 the time, and crabs were eaten with their butter 43% of the time.  Seafood
 cooking fluids were commonly drunk or used  in cooking.  These customs
 suggest that risk assessment methods include toxic chemical measurements
 in these tissues.

 The  study results also indicated that members  of the API community were
 interested in learning more about health issues surrounding eating fish, the
 safety of seafood from Puget Sound (the water body surrounding King
 County), and the safe preparation methods of seafood. The learning methods
 preferred by the APIs were  book/pamphlets (69%), verbal communication
 (55%), and video presentation (35%).  Community newspapers/newsletters
 were the most preferred information source (75%), followed by television
 (65%) and word of mouth (60%).

 The public health messages  developed during Phase III of the study were
 generally well received by API community focus groups. The brochure was
 viewed as helpful in decision making, and the presentation was considered
 clear and precise. Corrections and recommendations resulting from the focus
 group process have been incorporated into the final version of the brochure.
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 I.  Introduction

 Asian and Pacific Islanders (API), people having origins in the Far East,
 Southeast Asia, the Indian subcontinent, or the Pacific Islands, represent one
 of the most diverse and rapidly growing immigrant populations in the
 United States.  In 1997 API's (166,000 people) accounted for 10% of the King
 County, Washington population, an increase from 8% in 1990. Between 1990
 and 1997, the total population of King County increased 9% while the
 population of API's increased 43% (State of Washington Population Trends,
 1998).

 API immigrants and  refugees consider seafood collection and consumption as
 healthy activities that reflect a homelike lifestyle and may fish for economic
 necessity. For these reasons, API immigrants have been hypothesized to
 consume  greater quantities of seafood, differing species, and differing parts of
 seafood than the general United States (U.S.) population. Such cultural
 behaviors may increase their risk of toxic chemical exposure, especially
 among subsistence fishermen who obtain seafood in polluted urban sites. Yet,
 the API community has little information on the potential contamination in
 seafood consumed. Cultural and economic factors may put recent API
 immigrants at greater than expected risk from environmental exposures.

 Seafood consumption risk assessments within  ethnic groups require
 specialized survey tools because of cultural and language differences, as well
 as varying consumption and acquisition habits.  Only a few cases in the
 western United States for which reports are available:  e.g., the Columbia
 River Inter-tribal Fisheries  Commission (CRITFC), the Tulalip and Squaxin
 Island Tribes, and the Laotian Community of West Contra Costa County,
 California (CRITFC, 1994; Toy et al, 1996; Chiang, 1998, respectively).  The
 CRITFC survey (1994) included selected tribes in Washington and Oregon and
 estimated  per capita consumption at the 50th and 90th percentile of 41.5g/day
 and 127.2g/day, respectively. Fish consumption surveys were administered
 and reported jointly for a total of over 200 members of the Tulalip Tribes and
Squaxin Island Tribe of the Puget Sound Region (Toy, 1996).  The results
showed that the median daily per capita consumption rates for men were

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 53 g/day and 66 g/day for the two tribes, while women consumed a median	
 rate of 34 g/day and 25 g/day, respectively.

 Chiang (1998) surveyed the Laotian community (Laotian, Mien, Khmu,
 Thaidum) residing in the eastside of San Francisco Bay, in West Contra Costa
 County, California, using a "usual intake" consumption survey and
 calculated a mean per capita seafood consumption rate of 18 g/day. Chiang
 also reported that among 229 Laotian survey participants (87% of whom
 consumed seafood at least one time per month), fish skin was "always"
 consumed by 76% and "sometimes" by 23%; the head was "always" consumed
 by 20% and "sometimes" by 47%; and organs were "always" consumed by 6%
 and "sometimes" consumed by 41%.

 Considerable uncertainty regarding seafood consumption rates among APIs
 exists because studies reporting API seafood consumption and habits are  few
 and use different methodologies. However, these studies are valuable for
 providing insight into the scope of potential exposures. Javitz used 1973-74
 National Purchase Dietary data to calculate a mean per capita seafood
 (fresh/estuarine/marine) consumption rate for "orientals" (21 g/day). Three
 surveys conducted among API fishermen fishing in San Francisco Bay, Santa
 Monica Bay, and Los Angeles reported median seafood consumption rates  of
 43 g/day, 21 g/day, and 71 g/day, respectively (Wong, 1996; Allen, 1996; Puffer,
 1982).  These studies documented self-harvested seafood consumption rates
 only from specific fishing sites over varying periods of time (7 days, 4 weeks
 and "usual intake" per year, respectively),

 The U.S. EPA uses differing consumption rates depending on the regulatory
 program for which the assessment is being developed. Fish and seafood
 consumption rates are adopted only as U.S.  EPA policy with varying degrees
 of non-EPA review and  input.  The consumption rate which may have
 received the most intense scrutiny due to publication in the Federal Register
 and a subsequent comment period is the value included in EPA's  ambient
 water quality criteria (AWQC) recommendations developed under section
 304(a) of the Clean Water Act. In 1980, a  national average consumption rate
 of 6.5 grams per day (g/day) of fish and shellfish from estuarine and
 freshwaters was recommended.  This is the currently  used value.  This rate

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  was based on the mean per capita (both consumer and non-consumers)   	
  consumption rate of freshwater and estuarine finfish and shellfish from 3-day
  diary results that were reported in the 1973-74 National Purchase Diary
  Survey (Javitz, 1980). Proposed revisions to the AWQC methodology include
  a tiered approach for choosing an appropriate consumption rate (Federal
  Register: August 14,1998). The results from local or regional seafood intake
  surveys are preferred, while the last preference is use of defaults based, on the
  1989-91 Continuing Survey of Food Intake by Individuals (CSFII, 1990) data:
  17.8g/day for the general adult population and sport fishers, and 86.3/day for
 subsistence fishers.

 The U.S. EPA national Superfund program's policy is to assume an ingestion
 rate of 54g/day for high consumers of locally caught fish (OSWER). Region 10
 of the U.S. EPA,  which includes the State of Washington, recommends the
 use of results from local or regional seafood intake surveys for use in the
 regional Superfund program (U.S. EPA, 1991).

 The U.S. EPA Exposure Factors Handbook which can be used by any federal or
 state  program recommends a mean and 95th percentile  for the general U.S.
 population of 20.1 g/day and 63 g/day, respectively (U.S. EPA, 1997). For
 Native American subsistence populations the recommended  value  for mean
 intake is 70 g/day and the recommended 95th percentile is 170 g/day.

 The Washington State Department of Ecology recently recommended a
 statewide default  or" 177g/day to protect all Washington residents including
 the highest consumers, subsistence fishers  (Washington Department of
 Ecology, 1999).

 fl. Background

 Because of an increasing awareness in the risk of consuming certain seafood
 in the API community, the API community in King County, Washington,
 initiated a study to characterize seafood consumption patterns within their
 community. The  uniqueness of this evaluation included:  1) the community
 based approach throughout the study; 2) the large number of ethnic groups
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 participating; and 3) the partnership and interaction between the community
 and the researchers.

 The Refugee Federation Service Center (RFSC), which is the largest social aid
 organization for recent immigrants and refugees in King County,
 Washington, was established in 1982 by refugees for the provision of social
 services with an initial budget of $60,000. Today, the agency is a thriving
 organization and operates three facilities with a budget over $1 million. The
 agency is managed and staffed by refugees and remains a community-based
 organization through its affiliated seven Mutual Assistance Associations:
 Coalition of Lao Mutual  Assistance Association, East European Association,
 Ethiopian Community Mutual Association, Khmer Community of Seattle-
 King County, Vietnamese Friendship Association, Indochina Chinese
 Refugee Association, and Eritrean Community of Seattle and Vicinity.   The
 agency's most unique aspect is that the bilingual/bicultural staff and
 volunteers provide comfort that comes with speaking the native tongue and
 true understanding of what it means to be a refugee and an immigrant. The
 staff are familiar with the difficult transition to life in the U.S., culturally
 specific coping mechanisms, and specific concerns of their communities. In
 1995 the RFSC identified seafood consumption and subsequent
 contamination as a chief environmental justice issue of the API community.

 The study documented in this report involved ten API ethnic groups
 (Cambodian, Chinese, Filipino, Hmong, Japanese, Korean, Laotian, Mien,
 Samoan, Vietnamese) within King County, Washington. The community
 played an important role in the study, from the initiation of the study to the
 final report. During the study period, the researchers had frequent
 interactions with the community because the researchers viewed the study as
 "by the API community," instead of "for the API community." This
 interaction and cooperation helped the study team in its understanding of
 community concerns and therefore gained the support of the community,
 which was vital for the completion of this study involving ten ethnic groups
 with diverse cultural backgrounds.

The Refugee Federation Service Center and the University of Washington's
Environmental Health Department collaborated with three instrumental

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 committees to develop the study.  The planning, design, and development	
 were conducted by a Community Steering Committee comprised of members
 representing each ethnic group.  A Technical and an Advisory Committee
 also shared responsibility in the design of the study.  The Technical
 Committee was responsible for providing technical assistance, while the
 Advisory Committee provided recommendations to ensure the final study
 would be relevant to regulatory agencies, the medical field, industry, and
 businesses.

 Description and quantification of seafood consumption habits among API's in
 King County, Washington, was accomplished in three phases. The first,
 Phase I, consisted primarily with identifying the target ethnic groups,
 modification of the fish consumption and acquisition survey questionnaire
 used in the Tulalip and Squaxin Island Tribes Fish Consumption study (Toy,
 1996) to be culturally appropriate and accurate for the API community, and
 the translation of the questionnaire into the  native languages for the ethnic
 groups  being identified. The first phase of the study has been presented in the
 technical report to U.S. EPA (EPA, 1996).

 Phase II and Phase III of the evaluation, which were conducted jointly by the
 Refugee Federation Service Center and the University of Washington
 National Institute for Environmental Health Sciences (UW-NIEHS) Center
 for Ecogenetics and Environmental Health, were funded by the U.S. EPA
 Environmental Justice Community/University  Partnership Grant No. 66-604,
 and are described in this report. The specific  purposes of Phase II were to: 1)
 document the seafood consumption pattern and consumption rate of the API
 community; 2) document the sources of fish consumed by API members; and
 3) document educational approaches appropriate for the API community.
 The goals of Phase III were to: 1) identify culturally acceptable health messages
 related to seafood, 2) develop a brochure on seafood related health risks
 jointly with the community, and 3) field test  the brochure within the API
 community for understandability and cultural appropriateness.
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Ill IMPLEMENTATION  OF THE  STUDY  (PHASE  II)

A. METHODOLOGY
1. Overview
This study characterizes seafood consumption patterns of ten API ethnic
groups (Cambodian, Chinese, Filipino, Hmong, Japanese, Korean, Laotian,
Mien, Samoan, Vietnamese) within King County, Washington. Participants
were first or second generation members of the above ethnic groups, 18 years
of age or older, who lived in King County, Washington. Data were collected
using a survey questionnaire that was developed in English and later
translated into the respondent's native language. The surveys were
administered by trained bilingual  interviewers recruited from the API
community.  The questionnaire solicited information about the types of
seafood consumed, the source of the seafood, the preparation of seafood, the
frequency of and portion size consumption by the respondents, demographic
information, and educational approaches preferred by the respondents.

The study was conducted in three phases. While this report mainly addresses
only Phases II and III, a brief discussion of Phase I is included for background
and will assist the readers in understanding the approach and results
contained in this report. To promote reading clarity, some aspects of this
study's methodology appear in appendices.

B. COMMUNITY SUPPORT, STUDY  DESIGN,  QUESTIONNAIRE
   DEVELOPMENT  (PHASE  I)
The purpose of Phase I was: 1) to develop a framework which would interest
and involve API leaders in a seafood consumption and acquisition study; and
2) to develop a culturally acceptable survey instrument. To achieve these
goals, three committees were formed by  the Study Coordinator (SC) at the
RFSC. The SC was a resident of the local API community and belonged to
one of the ethnic groups  included in the study.
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  1.  Committee Guidance
  The Community Steering Committee (CSC). This committee's function was
  twofold: 1) to provide recommendations on specific cultural issues such as
  how to approach the community, language, and key concerns of the
  community; and 2) to provide community contacts  that would enable the
  networking and outreach efforts of the study's staff. The fifteen members of
  the committee each belonged to at least one of the ethnic groups being
  surveyed and had an affiliation with one or more community organizations
  (e.g., health care, education, religious or social organizations) within his or
  her respective community. Certain ethnic groups (e.g., Cambodian, Laotian,
  Vietnamese, Hmong and Mien) felt a strong vested interest in this study and
 sent more than one member.

 Technical Committee. The Technical Committee was responsible for: 1)
 advising the design of a scientifically sound questionnaire that took into
 account the cultural and language characteristics identified by the CSC for the
 ethnic groups involved; and 2) providing technical assistance to the CSC  for
 the feasibility and planning of the study.  Members included representatives
 from the U.S. EPA, King County Health Department, UW School of Fisheries,
 UW School of Public Health and Community  Medicine, Washington (WA)
 State Department of Health, WA State Department of Ecology, and two
 representatives from firms (Steven Gilbert, Ph.D., BioSupport, Inc. and
 Gregory L. Glass, Environmental Consultant).

 Advisory Committee.  The Advisory Committee's function was to provide
 recommendations to ensure that final documentation of the study would be
 relevant and applicable to different interested agencies and  ethnic groups.
 Members of the Advisory Committee included representatives of industry,
 health care, and regulatory agencies. Represented agencies included the
 Boeing Company, U.S. EPA, Puget Sound Keepers Alliance,  National Oceanic
 and Atmospheric Administration, Washington  State Department of Ecology,
 and the Community Coalition for Environmental Justice.
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 2. Development of Survey  Instruments
 a. Survey Questionnaire

 The Community Steering Committee deemed the use of creel, mail, or
 telephone surveys as culturally inappropriate and indicated that APIs would
 be unlikely to participate. Therefore, a face-to-face interview survey
 questionnaire was developed based on an earlier study by the Tulalip and the
 Squaxin Island Tribes of Washington (Toy et. al., 1996). The modification of
 this questionnaire was mostly completed in Phase I.  The Community
 Steering Committee was instrumental in guiding the selection of seafood
 species most often consumed by API as well as usual preparation methods
 and seafood tissue parts most frequently consumed.  Minor modifications of
 the questionnaire also occurred early in Phase II, for example, inclusion of 4
 educational outreach questions. Appendix  A contains the final questionnaire
 used in this study.

 The questionnaire  was first developed in English and subsequently translated
 into the languages of the ten ethnic groups. Focus groups tested the
 questionnaire within six ethnic groups (Cambodian,  Laotian,  Samoan,
 Korean, Filipino, Vietnamese) for content, format, wording, language,
 accuracy of translation, presentation, and use of visual displays during the
 development stage of the questionnaire. The focus group's feedback was used
 to enhance the questionnaire before it was finalized.

 The final questionnaire covered selected  demographic information of the
 respondents, the frequency and portion size for each seafood consumed by the
 respondent, the sources of the seafood, the preparation methods, and specific
 tissue parts consumed (for example, consumption of finfish skin,
 hepatopancreas of crabs, etc).

 b.  Visual Aids
To maximize the recall reliability in the survey, visual aids for administering
 the questionnaire were also developed during Phase I. One aid was plaster
models of seafood  representing approximate portion sizes (pre-cooked) of the
different species. Appendix B-l contains a picture of  these models, and
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  Appendix B-2 describes the weight of each model used for calculation of  	
  seafood consumption rates. A second aid was the species manual (Appendix
  C), a collection of pictures of the different seafood species. The manual was
  used to assist respondents in identifying partJaala£^p_ecigs-df-6eAfood. Pictures
  were obtained mainly from the Washington State Department of Fish and
  Wildlife,  Fishing in Washington, 1996 pamphlet edition. A copy of this
  booklet is provided with the purchase of every fishing or shellfish  collecting
  license. Pictures were available for most of the species, except snowfish and
  moonsnail. For moonsnail, actual moonsnail shells were available and
  therefore used. The species manual was especially important for the API
 community because the names of some species  (e.g., cockles, butter clams)
 could not be precisely translated as they are not generally collected or
 consumed in some respondents' native countries. The manual also included
 a map of the Puget Sound area. Interviewers used the map to help
 respondents identify seafood acquisition locations.  Seafood "caught from
 Puget Sound" was defined by interviewers as seafood caught within King
 County, Washington which borders on Puget Sound; and seafood "caught
 from outside Puget Sound" as defined as seafood from all other areas,
 including non-King County Puget Sound locations.  The expanse of Puget
 Sound goes far beyond the confines of King County, therefore to avoid
 confusion in this report, fishing areas will  be referred to as: within King
 County and outside of King County.

 c.  Determination of seafood  model  weights.

 Plaster models were cast from fish purchased from markets.  Individual
 models  could not be provided for the 21 finfish included in the survey.
 Therefore, all 21 finfish were represented by four models (Models A through
 D shown in Appendix B-l). The models represented the appropriate body
 shape and preferred  fish size for a group of finfish.  The selection of models
 and preferred fish size was determined by consensus of the CSC. Essentially,
 their guidance was that a fish must fit on a serving plate and effective models
 must be similar in body shape to the finfish in question, but did not have to
 be exact replicas in order  to evoke recognition.  Model A was the broad-bodied
 fish shape which was cast from a tilapia, and represented a serving of snapper,
 snowfish, rockfish, crappie, perch, bass, or tilapia. Model B was the  narrow-

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 bodied fish shape which was cast from a trout, and represented salmon,
 catfish, carp, sturgeon, and suckers.  Model C, the skinned fillet model,
 represented a typical serving of tuna, halibut, or cod.  Model D symbolized
 small, narrow-bodied fishes that the CSC advised were eaten whole or with
 the head attached, and represented smelt, dogfish, and herring. Other
 seafoods were individually represented by 16 models except that abalone and
 scallop were represented in one model, and shrimp and lobster were
 represented in one model.

 The weights used in the consumption rate calculations are shown in
 Appendix B-2. For models A, B, and D the measured weight in ounces of the
 uncooked fish from which the model was cast was multiplied by an ounces to
 grams conversion factor (28.35) and the percentage of edible meat in the
 whole body. The edible meat percentage was determined by methods
 described in Appendix B-3. The weight for model C was the measured weight
 of the uncooked fillets of the same approximate size. The weight of the
 shellfish (models J, K, L, M, N, O and T representing manila, macoma, horse,
 razor, geoduck and butter calms, and cockles, oysters, mussels and
 moonsnails, respectively) were the measured weights of the edible tissues
 after cooking and removal from the shell.  The weights for models I, E, F, R, S
 and H (abalone/scallop, sea urchin, shrimp/lobster, squid, sea cucumber and
 fresh sea weed/kelp, respectively) were the measured weights of uncooked
 samples of the same size. The weight for model G (dried seaweed) was the
 weight stated on the packaging. The weight for model F (crab) was determined
 from cooked crab meat plus crab "butter". .(See Appendix B-3). Crab "butter"
 consisted of the yellowish liquid and all of the easily removable soft tissue
 when the carapace is gently removed from the crab body.  The carapace is
 removed by turning the crab body upside down or tipping it sideways. The
 manner in which the carapace  is  removed intentionally captures as much of
 the yellowish liquid as possible, and the carapace, itself, may be used as a bowl
 to sip the liquid.
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 C.    SURVEY IMPLEMENTATION AND DATA ANALYSIS (PHASE II)
 The implementation of the survey and the data analyses were carried out in
 Phase II. Phase II included the recruitment and training of bilingual
 interviewers, questionnaire pilot testing and revision, development of
 sampling strategies, participant recruitment, survey administration, and the
 data analysis.

 1. Interviewer Recruitment, Training, and Quality Assurance

 a. Interviewer Recruitment
 The RFSC study coordinator recruited ten interviewers. The job openings
 were announced in local API newspapers and social service organiaations
 around King County. Job announcements were placed in API newspapers,
 flyers, and posted on local college and university campuses. The Community
 Steering Committee also recommended applicants. Each interviewer had to
 have a cultural knowledge  of at least one of the ten ethnic communities and
 be fluent in both English and the respective native language.

 b. Training and Quality Assurance
 Prior to interview, all interviewers attended  training on the skills of survey
 questioning and probing and use of seafood models. The 9-hour training (3
 hours daily for 3 days) was  provided by an experienced consultant Glide
 Ballard, Fred Hutchinson Cancer Research Center) who has directed many
 survey studies. Issues addressed included interviewer tasks, familiarity and
 proficiency with questionnaires, use of interview tools (e.g. models, maps),
 and data collection consistency.  After completing the training, interviewers
 were required to practice interviewing relatives and  friends over a two-week
 period.  Afterwards they conducted a simulated interview with the RFSC
 study coordinator (SC) using the  models and manuals. Once the SC deemed
 the interviewers proficient in  their interview and data recording techniques,
 interviewers were allowed to begin interviewing survey participants.  After
 each interviewer had administered two questionnaires to survey participants,
 the consulting statisticians reviewed the completed questionnaires for data
 consistency and counseled interviewers to improve data collection.
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 2 .    Questionnaire Pilot Testing
 Ten survey pilot tests were conducted by the trained interviewers to assess the.
 format of the questionnaire and the effectiveness of the seafood models. The
 test group had an equal number of males and females, at least one member of
 each ethnic group, at least one person from three identified age groups (18-39,
 40-64, 65+ years), at least 3 members who were first generation Americans
 and 3 who were second generation, and at least 2 people who identified
 fishing or collecting seafood as a major source of seafood consumed. Based
 on this pilot testing, translations were modified as needed to improve clarity
 and cultural appropriateness. Adjustments included translation corrections,
 re-phrasing of the questions, and the addition of questions related to cultural
 holidays.

 3.  Sampling Strategy
 An interview _goalj)f 200 respondents was planned. All respondents needed
 to meet pre-defined criteria to be included in the study. In this section, we will
 describe the criteria and the selection process of the respondents.

 a.  Respondent Selection Criteria

 Prospective participants of the study needed to meet the following
 requirements:
             1)  Membership in one of ten API ethnic groups: Cambodian,
                Chinese, Filipino, Hmong, Japanese, Korean, Laotian, Mien,
                Samoan, or Vietnamese;
             2)  At least 18 years of age;
             3)  Resident of King County, Washington;
             4)  Seafood consumer (non-consumers were documented during
                the recruitment process);
             5)  First generation (born outside US) or second generation
                American (at least  one of the parents was born outside US).

b.  Ethnic  Representation

The original sampling strategy specified that the ten API ethnic groups would
be represented in the sample proportionate to their composition as reported
in the 1990 US Census data for King County (see Table M-l). The Community

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 Steering Committee, however, had concerns about this strategy. They felt
 such an allocation of sample across ethnic groups purely based on the
 population size would polarize the community because: 1) certain groups
 appeared to be "preferred"; and 2) too few individuals would be interviewed
 from the API groups they felt to be most at risk; i.e., Cambodian, Hmong,
 Vietnamese, Laotian, Samoan, and Mien. The CSC considered Cambodian,
 Hmong, Vietnamese, Laotian,  Samoan and Mien to be less well-established
 socioeconomically because most (except Samoans) had come to the United
 States as refugees of war, and therefore,  were at a higher risk for subsisting on
 self-caught seafood. On the other hand,  other groups (i.e., Korean, Chinese,
 Japanese and Filipino) were viewed as relatively well-established in King
 County, more affluent, and less likely to collect seafood in contaminated
 waters, and therefore, more likely faced  a "lower risk". Taking account of the
 CSC's concern, the allocation of the  number of respondents was modified to
 their satisfaction, and it was decided to weight the results to reflect the API
 ethnic  group apportionment within King County when the final result was
 presented for the whole API community. (Table M-l).

 TABLE M-l. - SAMPLE SIZE BASED ON POPULATION PROPORTIONATE SAMPLING vs. ACTUAL SAMPLE SIZE
     BASED ON CSC'S RECOMMENDATION
Ethnic Group
Cambodian
Hmong
Laotian
Mien
Samoan
Vietnamese
Chinese
Filipino
Japanese
Korean
Total
Sample size allocation
based on census data
7
1
6
*
3
19
52
47
44
22
201
# of actual interviews
(CSC
recommendation)
20
5
20
10
10
26 (25)
30
30
30 (29)
22
202
Allocation principle
less well established
less well established
less well established
less well established
less well established
less well established
more established
more established
more established
more established

      •"Census data unavailable for this population.
4. Subject Recruitment
Because of the diversity of the ethnic groups covered in this study, no known
master list existed for all first and second generation Asian and Pacific
Islanders residing in King County. The lack of a complete sample frame
called for a special sampling approach in this study. Particularly, two
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 recruitment methods,  "roster" and "volunteer" approach, were employed	
 (described below). Both methods were used within each ethnic group, except
 for the Hmong community, in which all five interviewees were from roster.
 In the sampling design, the goal was to obtain one-half of the total
 participants via each method. In an effort to reduce possible selection bias
 based upon participants' knowledge that the study's focus was seafood
 consumption, the study was advertised as a Dietary Habits Study for Asian
 Pacific Islanders. A $25 check or grocery store gift certificate was offered as an
 incentive for study participation.

 Interviewers contacted respondents from a randomly constructed roster
 and/or volunteer  list by phone to arrange an interview appointment using a
 prepared telephone script (Appendix D) that was also translated into ten
 languages.  Interviewers documented their attempts to reach respondents on
 a record of contacts;  dates, times, and results of calls were recorded
 (Appendix E). Interviewers were instructed to contact respondents up to five
 times, but not to leave messages on answering machines.  If unable to speak
 with the respondent in person by their fifth attempt, interviewers were to
 proceed to the next respondent on  their list. For a completed interview, the
 respondent was paid for their participation.

 Once the number of respondents for each ethnic group was determined, the
 number of respondents was allocated equally between  "rosters" and
 "volunteers." To have a fair presentation of both genders, the percentage of
 each gender in the 1990 census data was used to decide the number of female
 and male respondents for each ethnic group.  Similarly, the percentage of
 people above and below the median age (1990 census data) of each gender
 within a specific ethnic group was used to approximately reflect the age
 composition of people in each ethnic group.

a.  Roster Recruitment
Though no complete list  of all API members existed in the community, a
variety of roster lists did exist within different API ethnic organizations.
These roster lists in the API community covered a portion of the API
members. It was planned to recruit about half of the respondents from
various roster lists in the API community. The SC contacted all known API

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  religious and community organizations to determine the sizes of their
  memberships.  Based upon these size estimates, organizations with sixty or
  more members were asked to share their membership rosters with the study.
  Approximately 50% of these religious and community organizations agreed
  to share their rosters after one introduction letter and a follow-up call from
  the SC.  To increase participation a second letter was sent out to those who
  had initial reservations about providing an organizational roster, which
  included a letter of support from Governor Gary Locke, the first Chinese
 American to be governor in the United States. (Appendix F.)  No additional
 organizations agreed to participate. Membership rosters from organizations
 that agreed to participate were used to randomly select potential study
 participants based on the size of the roster list.

 Once selected, a letter of introduction was sent to each potential participant
 containing two  response postcards, one in their native language and the other
 in English (Appendix G). A bilingual interviewer made a follow-up
 telephone call approximately a week later to ascertain the potential
 participant's qualifications (see Section IH.C3.a.), interest, age and gender.  If
 the qualified participant agreed and fit the needed age and gender profile, an
 interview was arranged.

 b.  Volunteer Recruitment
 Study planners anticipated problems obtaining a sufficient number of
 participants through the roster method, as well as possible selection bias based
 on the membership in a  religious organization or  community group.
 Therefore, a second pool of participants, volunteers, was sought from which
 to randomly select the remaining half of the participants needed for the study.
 This second group of potential participants was referred to as/'volunteers."

 Recruitment of volunteers was achieved in a number of ways. Between
 March and April 1997, press releases were published in API newsletters, local
 newspapers, and community organizations' and UW newsletters. Shortly
 afterwards, approximately 1000 posters (Appendix H) in the ten ethnic
 languages and English were posted  within King County in areas believed to
be frequented by API members: e.g., groceries, community organizations,
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 churches, UW campus, and area parking lots. Attached to the posters were	
 bilingual postcards (e.g., if the poster was displayed in a Korean establish-
 ment, the postage-paid postcards would be in Korean and English), deliver-
 able to the UW.  In addition, word of mouth, solicitation from various
 community and church leaders, and the RFSC staff encouraged and increased
 the participation in the study. The  volunteer category (from post cards and
 lists submitted by the RFSC) identified 476 individuals for the dietary habit
 survey.

 As the postcards were received at  the UW, the information provided on the
 postcard (names, addresses, phone numbers, ethnicity, age, and gender)  was
 entered into a database maintained in a secure area at UW. The consulting
 statisticians then randomly selected volunteers from  the database and
 transmitted the names to interviewers. Letters indicating selection for study
 participation were mailed to the selected volunteer category participants, and
 a bilingual interviewer contacted them one week later to set up an interview.

 As the study progressed, it was discovered that some minor adjustment was
 necessary to enable timely completion of the data collection phase.
 Particularly, the preset age and gender sampling allocations could not be
 strictly met within some ethnic groups because of insufficient names on
 either volunteer or roster lists.  Among Japanese and Cambodian participants,
 five people from the volunteer category were substituted when sufficient
 roster members of the needed gender and age were not available, respectively.
 Also, within the Japanese and Filipino groups there was difficulty locating
 individuals between the ages of 18-37.  Therefore, relatives of roster selectees
 within the same age group were recruited, though only one study participant
 per family participated in  the survey.

 5.  Questionnaire Administration

 Interviews were conducted during the spring and summer of 1997 at
 convenient locations preferred by the study respondent (e.g., residence,
 church, restaurants, respondents' work location, RFSC office). In some cases,
 the interviews were conducted in the respondent's native language. During
 the interviews, interviewers showed participants seafood models and pictures

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 of seafood to help respondents identify types of seafood and the portion sizes
 consumed.  Interview duration averaged 59 minutes (range: 25-120 minutes).
 Respondents who were interviewed received monetary compensation of
 $25.00.

 a.  Re-interviews
 During the initial interview, respondents were given the option of signing a
 "Consent For Future Contact" form (Appendix I) for a potential re-interview.
 From these,  twenty  survey respondents were randomly selected, 10%
 proportionately from each ethnic group, e.g. three each from the Chinese,
 Japanese and Korean groups, one from the Mien group, etc. for re-interview
 via telephone using the re-interview questionnaire, which was a subset of the
 questions contained in  the main survey questionnaire (Appendix J). This re-
 interview was used  to check the reliability of responses on the earlier survey
 and participants were selected as  soon as all 202 surveys were completed.
 Respondents who were re-interviewed received an additional $10
 compensation.

 b.  Questionnaire  Editing

 Completed surveys were subjected to an editing process between the SC and
 the interviewer. This editing process was used to screen and verify answers
 that were ambiguous or inconsistent. In the editing process, logic  validation
 of answers (within field checks for values in the possible range and between-
 field checks for relationships) was also carried out. The editing was completed
 before the questionnaires were sent for data entry.

 c.  Double-key Data Entry

 To minimize  the data entry error,  a  "double key-entry" procedure  was
 employed. The data entry was done initially for all questionnaires. After the
 first data entry, the data entry program was set as the "verification" mode and
 a second  round of data entry was done for all data fields and for all
 questionnaires. This "verification" mode of the data entry prompted the data
 entry staff with an on-screen error message  if any inconsistency occurred for
 the data field being entered.
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 6.  Data Analyses
 When the data entry was completed, the data were transferred to the
 consulting statisticians for data analysis. For each seafood species, the answers
 of each respondent were converted into a consumption rate based on the
 frequency and the portion size as reported in the survey.

 a.  Statistical  Methods

 1) Consumption Rate.  Seafood species were categorized into seven groups:
 anadromous, pelagic, freshwater, bottom, shellfish, sea weed/kelp, and
 miscellaneous seafood (see Appendix K) for surveyed species within each
 group. Anadromous, pelagic, freshwater and bottom fish were further
 combined into the "finfish"  category. Finfish, shellfish,  and miscellaneous
 seafood were used to compute the "all fish" category. "All fish" and
 "sea weed/kelp" were aggregated into "all seafood."

 The reported total amount consumed per year was computed for each of the
 above seafood groups. The daily consumption amount for each person was
 then calculated by dividing the annual amount by 365 days. The daily average
 amount was further adjusted for the body weight of the  respondent (based
 upon self-reported body weight), yielding a common daily consumption rate
 across all respondents (grams/per kilogram body weight/per day, or
 g/kg/day).

 Consumption  Rate =  (# annual servings x portion size  in grams)/
                     (365 days x kg body weight)

 The adjustment was necessary for comparison across different ethnic groups
 and across other demographic characteristics. All results will be reported
 using this common unit of g/kg/day, unless otherwise stated. This unit of
 "g/kg/day" has been used and reported in other fish consumption studies as
 well (Toy, 1996). Non-consumers of a specific fish species were assigned a
 consumption rate of zero and were included in the data  analysis and
 reporting.
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  2) Treatment of outliers. A number of respondents reported unusually large
  consumption rates in this study. For example, the largest consumption rate
  reported for shellfish was approximately 11.83g/kg/day (see table of Outliers
  and Substitution in Appendix L). Values such as these represent large but
  uncertain consumption rates. Generally, these unusually large values are
  referred as "outliers."

  Because outliers may have  profound influence on the average and potentially
  other summary statistics, special treatment for them is warranted. In  this
  study, the outliers were identified as those with an observed value greater
  than 3 standard  deviations  above the mean for consumers of the specific
 seafood group of interest. All outliers were identified within each fish
 category and substituted by a smaller value that equals to the mean plus 3
 standard deviations.

 The treatment of outliers involved three steps. Firstly, all observed values  in
 individual seafood category (anadromous, pelagic, freshwater, bottom,
 shellfish, seaweed/kelp, miscellaneous) that were greater than three standard
 deviations (SD) above the mean of all consumers were identified  as outliers,
 and these outliers were then substituted by mean-f 3SD (the rule of "mean
 plus three standard deviations").

 Secondly, after the treatment of outliers for each of the individual seafood
 categories, the "all seafood" consumption rate was computed as the sum of all
 individual seafood sub-categories. Using the same principle as applied in
 individual seafood sub-categories, the outliers in the "all seafood" category
 was also adjusted downward to a value of mean+3SD.

 The last step in the treatment process of outliers involved a  re-adjustment of
 consumption rates of sub-categories for these respondents who were outliers
 in the "all seafood" category. To reflect the fact that the overall "all seafood"
 rate was the sum of the individual seafood categories, all the individual
 seafood categories (the components used in the computation of "all seafood")
 were re-adjusted proportionately using the percentage of each sub-category in
 the "all seafood" multiplied  by the re-adjusted "all seafood" rate.
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 All results in this report are based on values after the substitution of the
 outliers. Appendix L lists specific values that were receded based on the rules
 of treatment of outliers. These values, along with the means and standard
 errors reported in the tables, are sufficient statistics for recalculation should
 the reader wish to recalculate means, standard errors, and confidence
 intervals,  with  outlier values as originally reported.

 3) Hypothesis testing and statistical significance. Analyses of consumption
 rates (g/kg/day) are presented in terms of mean, standard error, median (the
 50th percentile), and percentiles. The 95% confidence interval on the mean is
 also presented for the consumption rates for each ethnicity group. The
 statistical significance of difference in consumption rates by ethnicity, gender,
 age, income level, and fishing activity was also calculated.  Due to the
 occurrence of right skewed distribution (because of a few fairly large values)
 in the observed consumption rates, nonparametric methods, which are based
 on the ranked data and are  more robust against skewness than parametric
 tests, were used in the assessment of the statistical significance. When
 comparing consumption rates between or across  groups, either the Wilcoxon-
 Mann-Whitney  test or the Kruskal-Wallis test was used, depending on the
 number of groups being compared (Fisher and Van Belle 1993). In this report,
 p<0.05 is considered statistically significant. Since there are many hypothesis
 tests and associated p-values, some results may be significant by chance alone.
 Readers are encouraged to note that no formal methods of adjusting this
 "multiple testing problem" were used  in this report. Interpretation of
 statistical significance should take into account the number of tests (p-values)
 performed in the area of comparison to the reader.

 4) Calculation of means, standard errors, confidence interval, and percentiles
 of consumption  rates.  The  arithmetic  mean (average) consumption rate
 (g/kg/day) was calculated for each ethnic group. All 202 survey respondents
 were used  in the computation. However, if a respondent did not consume a
 specific seafood  species, the  consumption rate of zero was assigned for the
 seafood species.  The observed standard error was also calculated. The 95%
 confidence interval on the mean for each ethnic group was  constructed based
 on the Student t-distribution. The median (50th percentile) and other
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  percentile were also presented for the ethnic groups with at least ten
  respondents.

  The arithmetic mean, standard error, median, and other percentiles were also
  calculated for all 202 respondents by gender, by source of respondents (roster
  list vs. volunteer), by age group, and by income level.

  5) Calculation of means, standard errors, confidence  interval and percentiles
 for API community using weighted methods. Ten ethnicity groups of the
  Asian and Pacific Islander community were included in this survey. When
  the survey results were aggregated into the average consumption rate for the
 whole API community, different weights were applied to the mean for each
 ethnic group. The weighting was necessary to adjust  for the composition
 (proportion) of the ethnic groups in the API  community. When the mean
 consumption rate was computed for the API  community, the proportion (P,)
 of each ethnicity of the API community was used as the weight for mean of
 each ethnicity. This weighting scheme by population  percentage took into
 account the underlying population structure of the API community.
 Specifically, the average consumption rate for the entire API community was
 calculated as
 where x, is the average for the /'* group, and P, is the population percentage of
 that ethnic group in the API community. The standard error of the average
 consumption rate for API was then computed as
where var(.v,)is the observed variance for the ith group.

A different weighting scheme was used when the median and other
percentiles were calculated for the entire API community. All observed
consumption rates in a specific ethnic group are applied the same weight --
the ratio of the population proportion (P,) of the corresponding ethnicity and
the number of the surveys (P, / //,), with  P, the population percentage of that

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 ethnic group in the API community and n,the number of survey respondents
 for the i'h group. This weighting scheme for the percentiles took into account
 both the population proportion and the number of surveys in the sample.
 The median was then calculated as the sorted rates (from the lowest to the
 largest) that corresponded to the 50th percentile on the accumulated weights
 across all respondents (all weights add up to 1). Other percentiles were also
 obtained  in the same manner as the median, using the combination of the
 sorted consumption rates and the accumulated weights.

 The weighting was only applied in the calculation in the consumption rates
 for all 202 respondents combined. No weighting was used for the
 computation of rates by ethnicity, gender, age, income, education, participant
 category (roster versus volunteer), fishing status, generational status or
 consumption category (high versus low).

 IV   Survey Results (Phase II)
 A. PARTICIPATION RATE
 Survey participation rates differed between the volunteer and roster
 categories. Those in the volunteer category had already indicated their
 willingness to participate by sending in a postcard. Within this group (n=462),
 interviewers attempted to contact 150 individuals. Of these, 16% could not be
 contacted. Of those contacted, 13% were disqualified because they did not
 meet all of the selection criteria outlined in Section Ill.C.S.a. or did  not fit into
 needed age and gender categories. Excluding the disqualified, the
 participation rate within the volunteer group was 96%. Within the roster
 category 365 contacts were attempted.  Of these, 54% could not be contacted,
 and  14% did not meet selection criteria.  Excluding the disqualified, the
 participation rate in the  roster group was 67% with 33% refusing
 participation. See table in Appendix M-l-a.  Non-consumption of fish was
 considered a disqualifier for 0% of the volunteer category and 2% of the roster
 category.
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 B. DESCRIPTIVE  STATISTICS

 The majority of the  202 respondents (89%) were first generation who were
 born outside the United States. The remaining 11% of the respondents were
 born in the United States, but at least one of their parents was born outside
 the United States. Forty percent (40%) of the respondents had completed
 college, and 13% had an education level less  than high school.

 As described in Table M-l, the 202 respondents in this  study came from ten
 ethnic groups. Of these 202 respondents, there were slightly more women
 (n=107, or 53%) than men (n=95, or 47%). The average body weight for men
 and women in the sample was 70kg (SD=12kg) and 57kg (SD=13kg),
 respectively. However, the sampled Samoans weighed more than other API
 groups. The average weight was 99kg for Samoan men (n=5, SD=19kg) and 95
 kg for Samoan women (n=5, SD=16kg). The body weight for other ethnic
 groups was more homogeneous. The average body weight ranged from 52kg
 to 63  kg for women in the other 9 ethnic groups, and from 60kg to 73kg for
 men in the other ethnic groups. Ninety-six (or 48%) of the respondents were
 recruited from the community roster  lists, and the remaining 106
 respondents (or 52%) were from the volunteer category. The majority of the
 respondents were under age 55 (n=163, or 81%), and people 55 years or over
 accounted for 19%.

 Household income, reported as  income intervals, was provided by 187
 respondents. The mid-point of the household income  intervals was adjusted
 for the number of  people in the household and compared with 1997 Federal
 Poverty Level (FPL). Overall, 35%  of the 202 respondents in the sample lived
 under the 1997 poverty line. However, the percent of respondents living
 under the FPL was not uniform among the ethnic groups. A greater
 percentage of people living under  FPL was observed for the Samoan
 community and those ethnic groups with the majority members  being
 refugees: Mien, Laotian, Cambodian, and  Vietnamese.  Samoan (90%)  had  the
 highest percentage of respondents  under FPL, followed by Vietnamese (62%),
 Mien  (60%), Cambodian (50%), Laotian (45%), Korean (32%), Chinese  (26%),
 Filipino (21%), Japanese (6%) and Hmong (0%).  In 1990, the percentage of all
 API in King County living under the FPL was 14.8%. Respondents recruited
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 from community rosters had a slightly higher percentage of people living
 under FPL than the volunteer category respondents (39% versus 32%) did.

 C. SEAFOOD  CONSUMPTION RATES

 1.  Consumption rate for the API community

 The main object of this study was to estimate the seafood consumption for
 the entire Asian Pacific Islander community in King County, Washington.
 The consumption rates for API were aggregated for the ten ethnic groups
 included in this study using the weighting methodology as described in the
 methods section.

 All 202 respondents were fish consumers. Only one person (0.5%) did not eat
 shellfish. The percentages of consumers of anadromous, pelagic, freshwater,
 bottom fish, and sea weed/kelp were 96%, 97%, 86%, 81%, and 57%,
 respectively. The relatively low percentage of the respondents eating
 seaweed/kelp was due to the fact that seaweed and kelp were primarily
 consumed by the Chinese, Japanese, and Korean communities. Only a few
 members of other API ethnic groups ate seaweed and kelp.

 In general, the API members consumed seafood at a very high rate (see Table
 R-l). The average overall consumption rate for all seafood combined was
 1.891 g/kg/day (median 1.439 g/kg/day). The predominant seafood consumed
 by API was shellfish (45.9% of all seafood consumed by APIs). The API
 community consumed more shellfish (average consumption rate of 0.867
 g/kg/day) than all finfish combined (an average rate of 0.819g/kg/day).

 Within the category of finfish, pelagic fish were most consumed by the API
 members, averaging 0.382 g/kg/day (median 0.215 g/kg/day), followed by
 anadromous fish with an average consumption rate of 0.201  g/kg/day
 (median 0.093 g/kg/day). The average consumption for freshwater fish was
 0.110 g/kg/day (median 0.043 g/kg/day), and bottom fish was 0.125 g/kg/day
 (median 0.047 g/kg/day).

 In addition, to the seafood specifically listed in the questionnaire, survey
 respondents were asked if they consumed other types of seafood.  For this

API Seafood Consumption Study        27EPA 910/R-99-003
5/27/99

-------
 report, these seafood were classified as "miscellaneous seafood". A
 substantial quantity of "miscellaneous seafood" was consumed by the API
 members, much of which was canned or preserved fish. On the average,
 respondents reported a consumption rate of 0.121 g/kg/day of miscellaneous
 seafood (median 0.056 g/kg/day). See Appendix M-l-b for the listing of
 miscellaneous seafood by percentage of study participants who  consume
 them. Fish consumption rates were skewed considerably for all fish groups.
 The skewed distribution indicates that a few respondents had a  larger
 consumption rate than other respondents. Because outliers had already been
 adjusted within each fish group (see Methodology section), these large
 consumption rates reflected the fact that some API members were, indeed,
 "higher" consumers of seafood.

 TABLE R-l. CONSUMPTION RATES OF API COMMUNITY MEMBERS
1 Category N
Anadromous 202
Fish
Pelagic Fish 202
Freshwater 202
Fish
Bottom 202
Fish
Shellfish 202
Fish
Seaweed/Kel 202
P
Miscellaneo 202
us Seafood
All Finfish 202
All Fish 202
All Seafood 202
Median
g/kg/d
0.093
0.215
0.043

0.047

0.498

0.014

0.056

0.515
1.363
1.439
Mean
g/kg/d
0.201
0.382
0.110

0.125

0.867

0.084

0.121

0.818
1.807
1.891
Percentage of
consumption
10.6%
20.2%
5.8%

6.6%

45.9%

4.4%

6.4%

43.3%
95.6%
100.0%
S.E.
0.008
0.013
0.005

0.006

0.023

0.005

0.004

0.023
0.042
0.043
95% LCI
g/kg/d
0.187
0.357
0.101

0.113

0.821

0.075

0.112

0.774
1.724
1.805
95%UCI
g/kg/d
0.216
0.407
0.119

0.137

0.913

0.093

0.130

0.863
1.889
1.976
90%tile
g/kg/d
0.509
0.829
0.271

0.272

1.727

0.294

0.296

1.638
3.909
3.928
      95%LCI = 957c lower confidence interval bound; 95%UCI=95% upper confidence interval. The
      confidence interval was computed based on the Student's t-distribution. Rates were weighted
      across ethnic groups.

To better characterize individuals consuming large quantities of seafood,
survey participants were classified as "higher" (n=44) or "lower" (n=158)
consumers of shellfish or finfish  if their consumption rates were > 75th or <
API Seafood Consumption Study
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 75th percentile, respectively. Appendix M-2 shows demographic and seafood
 preparation characteristics of each group.  For finfish, a greater percentage of
 women fell into the "higher" finfish consumers (24%) than men (19%).
 Japanese had a greater percentage of "higher" finfish consumers.  More
 individuals >55 years (36%) were in the "higher" consumer category for all
 finfish. Cambodian (10%), Mien (10%), Korean (9%), Hmong (0%) and
 Samoan (0%) participants tended to be "lower" consumers of finfish. Each
 consumption group had similar preparation and procurement practices for
 finfish. Frequency of finfish skin or heads/bones/organs consumption did
 not differ between groups. For shellfish, more women were "higher"
 shellfish consumers (29%)  than men (21%) were. A greater percentage of
 Vietnamese (50%) were in the "higher" consumer category for shellfish. Mien
 (10%), Hmong (0%) and Samoan (0%) participants tended to be "lower"
 consumers of shellfish. Only 7% of "higher" consumers harvested (by self,
 family members or friends) shellfish.

 2.  Consumption  rate by ethnicity

 The study was designed to include the participation of members of ten API
 ethnic groups. Because of the small number of respondents for some ethnic
 groups in the study, it is not feasible to estimate the consumption rates for
 each ethnic group accurately. Nevertheless, differences in the pattern of
 seafood consumption can be observed from the data.

 The detailed Seafood Consumption Rates by Ethnicity Table in Appendix M-3
 suggests that the ten ethnic groups did not consume seafood uniformly.
 There was a statistically significant difference (Kruskal-Wallis test) in all
 consumption rates (anadromous, pelagic,  freshwater, bottom fish,
 sea weed/kelp, miscellaneous seafood, shellfish,  and the aggregated categories
 of finfish, all fish, and all seafood) among the ten API ethnic groups.

 In general, members of the Vietnamese and Japanese communities had the
 highest overall consumption rate of all seafood, averaging 2.627 g/kg/day
 (median 2.384 g/kg/day) and 2.182 g/kg/day (median 1.830 g/kg/day),
 respectively.  On the other end of the spectrum, the Mien, Hmong, and
Samoan communities consumed the least amount  of seafood. The overall
API Seafood Consumption Study        29                    EPA 910/R-99-003
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-------
 consumption rate of all seafood for Miens was 0.580 g/kg/day (median 0.288^
 g/kg/day), less than one-third of that of Vietnamese community. Hmong
 people consumed 0.587 g/kg/day on the average (median 0.521g/kg/day). The
 Samoan community ate about 0.850 g/kg/day of all seafood on the average
 (median 0.879g/kg/day).

 For specific seafood categories, the amount consumed differed among the
 communities. The Japanese community reported the largest consumption of
 anadromous fish,'pelagic fish, and miscellaneous seafood. Members of
 Vietnamese community had the  largest consumption of shellfish and
 freshwater fish of the ten ethnic  groups. The Korean community consumed
 the most seaweed and kelp, followed by the Japanese and the Chinese groups.

 3.  Consumption rate by gender

 Of the 202 respondents, 107 were women and 95 were men. The survey data
 showed that in general women ate slightly more seafood after adjusting for
 body weight. However, there was no statistically significant difference in the
 consumption rates between men and women for all the fish groups and the
 combined categories, after adjusting for body weight. The average
 consumption rate for all seafood for women was 1.807 g/kg/day (median
 1.417g/kg/day), and 1.710g/kg/day (median 1.257g/kg/day) for men. Results in
 Table R-2 indicate that women had a slightly greater average consumption
 rate for all fish groups, except for  anadromous and freshwater fish. Appendix
 M-4 shows seafood consumption rates by ethnicity and gender.
API Seafood Consumption Study         30                   EPA 910/R-99-003
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 TABLE R-2 CONSUMPTION RATES BY GENDER FOR ALL ASIAN AND PACIFIC ISLANDER COMMUNITY
                                   Female
          Category
                               g/kg/d
    SE  Median   n
        g/kg/d
g/kg/d
SE  Median
     g/kg/d
Anadromous Fish (p=0.8)
Pelagic Fish (p=0.4)
Freshwater (p=1.0)
Bottom Fish (p=0.6)
Shellfish (p=0.8)
Seaweed/Kelp (p=0.5)
Miscellaneous Seafood (p=0.5)
All Finfish (p=0.8)
All Fish (p=0.5)
All Seafood (p=0.4)
107
107
107
107
107
107
107
107
107
107
0.165
0.349
0.131
0.115
0.864
0.079
0.105
0.759
1.728
1.807
0.022
0.037
0.021
0.019
0.086
0.018
0.013
0.071
0.135
0.139
0.076
0.215
0.054
0.040
0.432
0.005
0.061
0.512
1.328
1.417
95
95
95
95
95
95
95
95
95
95
0.169
0.334
0.137
0.087
0.836
0.044
0.104
0.726
1.666
1.710
0.024
0.045
0.023
0.017
0.104
0.010
0.015
0.072
0.149
0.152
II _ .!...»__.. ^
0.080
0.148
0.054
0.034
0.490
0.002
0.055
0.458
1.202
1.257
       P-values are based on Mann-Whitney test.

4. Consumption rate by age

Respondents were classified into three age groups: 18-29, 30-54, and 55 and
over. Overall, people in the 55 and over age group ate more seafood than
people did in the other two age categories. The average consumption rate for
the 55 and over age group was 2.065g/kg/day, compared with 1.752 and 1.631
g/kg/day for the age groups of 18-29 and 30-54 age groups, respectively. The
same pattern was observed for all other fish groups, except for pelagic and
miscellaneous seafood. However, the differences in the consumption rates of
fish by age were not statistically significant except for anadromous fish. (See
Appendix M-5).

5. Consumption rate by income

Household income along with the number of people depending on the
reported income was used to compare with the 1997 Federal Poverty Level
(FPL). One hundred eighty-seven (93%) of the 202 respondents provided the
income information in the survey. These respondents with known
household income and number of people in the household were grouped
API Seafood Consumption Study
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  into four income levels: under the FPL, 1-2 times FPL, 2-3 times FPL, and
  more than 3 times FPL.

  There was no clear pattern of consumption rates across income levels for the
  API community. (See Appendix M-6). The difference in the average
  consumption rate of all seafood  was about 20% across the 4 income levels,
  indicating people in all the income levels consumed approximately same
  amount of seafood. People in the lowest income level (under FPL) ate more
  in the categories of all seafood, all fish, and shellfish, but  none of the
 difference was statistically significant.

 6. Consumption rate by educational level
 Seafood consumption was cofnpared by educational level achieved (high
 school or less versus more than high school).  (See Appendix M-7). No clear
 pattern was observed except seaweed/kelp, and miscellaneous seafood
 consumption were significantly higher in those with greater than  a high
 school education, and more freshwater fish was consumed by those with less
 than a high school  education. The higher consumption of sea weed/kelp
 among those with more education probably reflects its consumption
 preference among the "more established" API groups (e.g., Japanese, Chinese
 and Korean).

 7. Consumption rate by roster category and volunteer category
 Respondents in this study were  recruited from volunteers and community
 roster lists. Ninety-six of the interviews were from roster lists, and the
 remaining  106 participants were volunteers from the ten different
 participating communities. Eighty-eight percent of volunteer participants
 and 90% of roster participants were first generation.
 The consumption rates from the  volunteer category  were  similar to those of
 the roster list participants  (Table R-3). The overall consumption rate of all
 seafood for volunteer category was slightly higher than that for people from
 roster lists (average  1.811 vs. 1.707 g/kg/day).   Participants from the volunteer
 category ate more fish than the respondents recruited from roster category in
 all finfish, all fish, and all  seafood. Nevertheless, none of  the differences was
 statistically significant.  Appendix M-8 shows roster and volunteer

API Seafood Consumption Study         32                    EPA 910/R-99-003
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-------
 consumption rates for all seafood categories, e.g. andromous fish, pelagic fish,
 etc.

 TABLE R-3. CONSUMPTION RATES BY ROSTER AND VOLUNTEER
Category
Shellfish Fish (p=0.4)

All Finfish (p=0.4)

All Fish (p=0.5)

All Seafood (p=0.5)

Resource
Roster
Volunteer
Roster
Volunteer
Roster
Volunteer
Roster
Volunteer
n
96
106
96
106
96
106
96
106
Mean
g/kg/d
0.873
0.831
0.698
0.785
1.662
1.733
1.707
1.811
SE
0.109
0.081
0.070
0.072
0.149
0.135
0.152
0.139
Median
g/kg/d
0.422
0.494
0.452
0.494
1.129
1.409
1.206
1.477
       P-values are based on Mann-Whitney test

 8.     Consumption rate by fishermen and non-fishermen

 Respondents in this study were also asked if they fish. Overall, 66 (33%) of the
 202 respondents indicated that they "fish". For simplicity, we will refer these
 66 people as "fishermen" and the remaining 136 respondents as "non-
 fishermen." The income level (as measured by 1997 FPL) did not show
 significant difference between the "fishermen" and "non-fishermen" groups.
 Twenty-four percent of female and 42% of male  participants were fishermen.

 The overall consumption rate (Table R-4) of all seafood for "fishermen" was
 slightly greater than that for "non-fishermen" (average 1.971 vs. 1.660
 g/kg/day).  "Fishermen" consumed more fish than "non-fishermen"  in all
 finfish, all fish, all seafood, and all sub-fish categories, except freshwater fish
 and seaweed/kelp.  However, the difference in the consumption rate between
 "fishermen" and "non-fishermen" was not statistically significant in the
 three aggregated fish categories: "all finfish," "all fish," and "all seafood."
API Seafood Consumption Study
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 TABLE R-4. CONSUMPTION RATES BY "FISHERMEN" AND "NON-FISHERMEN"
Category
••••••••••
Shellfish Fish (p=0.4)

All Finfish (p=0.2)

All Fish (p=0.3)

All Seafood (p=0.2)

Resource
i^mmmmmm
Fishermen
Non-fishermen
Fishermen
Non-fishermen
Fishermen
Non-fishermen
Fishermen
Non-fishermen

mmm*
66
136
66
136
66
136
66
136
Mean
g/kg/d
0.889
0.833
0.879
0.678
1.879
1.612
1.971
1.660
SE
0.116
0.082
0.101
0.056
0.188
0.117
0.192
0.120
Median
g/kg/d
0.498
0.428
0.616
0.437
1.357
1.254
1.531
1.254
       P-values are based on Kruskal-Wallis test.

 9.  Consumption rate by generation

 First (people born outside U.S.) or second (people born inside U.S. but who
 have at least one parent born outside U.S.) generation APIs were eligible for
 this study but only 11% of participants were second generation.  Participants
 from South East Asian countries (Cambodian, Laotian, Mien, Hmong and
 Vietnamese) were all first generation. Among the remaining ethnic groups
 60% of Samoan, 69% of Japanese, 83% of Chinese, 87% of Filipino, and 95% of
 Korean were first generation.  Table R-5 shows a trend toward higher incomes
 among second generation participants.

 TABLE R-5 GENERATION BY INCOME
Income Level
Under FPL
1-2 FPL
2-3 FPL
>3FPL
Total
Second Generation (born
n in US)
71
39
38
39
187
9%
8%
13%
18%
11%
First Generation (born
outside US)
91%
92%
87%
82%
89%
In general, first generation APIs consumed more fish than the second
generation API in all the fish categories, except pelagic fish.  The consumption
rates are statistically different between the first and second generation for the
following seafood categories: freshwater fish and shellfish (Table R-6).
API Seafood Consumption Study
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34
EPA910/R-99-003

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 TABLE R-6 SEAFOOD CONSUMPTION BY GENERATION
                            Second  Generation
                                  (n=23)
                             Mean       SE
                             g/kg/d   ;
                First Generation
                   (n=;179>
               • Mean'-X-^wSE:
               g/kg/d  7'
Anadromous Fish (p=0.1)
Pelagic Fish (p=0.08)
Freshwater Fish (p<0.001)
Bottom Fish(p=0.1)
Shellfish (p=0.043)
Seaweed/kelp (p=0.055)
Miscellaneous Fish(p=0.9)
All Finfish (p=0.8)
All Fish (p=0.2)
All Seafood (p=0.3)
0.132
0.377
0.020
0.088
0.445
0.068
0.097
0.616
1.158
1.226
0.018
0.058
0.005
0.018
0.070
0.025
0.025
0.074
0.126
0.135
0.171
0.338
0.148
0.103
0.903
0.062
0.106
0.760
1.769
1.830
0.018
0.032
0.017
0.014
0.074
0.012
0.010
0.056
0.111
0.114
       P-value is based on Mann-Whitney test.
 D.  FISH SOURCES
 Respondents were asked to report the sources [grocery stores/street vendors;
 restaurants; harvested (by self, family member or friend) in King County,
 Washington; harvested outside King County] where they acquired the
 seafood they consumed. The main source of all forms of fish consumed by
 API community was purchased from grocery stores, street vendors, or
 restaurants, ranging from a low of 79% to a high of 97% across types of
 seafood (see Table R-7). Eighty-five percent of anadromous fish consumed
 were purchased from grocery/street vendors or restaurants. Ninety-three
 percent pelagic fish, 79% freshwater fish, 83% bottom fish, 88% shellfish, and
 97% seaweed/kelp were purchased as well.

 The harvested portion of the consumed seafood by API community members
 varied from a low 3% to a high of 21%, depending on the seafood type. The
 main harvest sites tended to be in King County. Questioning about other
 harvest sites was not pursued because the Community Steering Committee
 felt that more explicit questioning about harvest sites was culturally
 intrusive.

Overall, the harvested portion of the fish consumed by the API community
was less than a quarter of the total consumption; nevertheless, differences can
API Seafood Consumption Study
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 be observed among the ethnic groups. Respondents in the Japanese, Chinese^
 Filipino and Korean groups tended to consume purchased seafood.  Members
 of the Mien, Hmong and Laotian communities seemed to harvest seafood
 more often than other ethnic groups (See Appendix M-9). Laotians, for
 example, harvested 43% of bottom fish. Miens harvested more than half of
 anadromous fish, 100% of bottom fish, and 34% of shellfish. However, only
 ten Mien respondents were selected for this survey, and their overall seafood
 consumption rate was the lowest among all ethnic groups.


Category

Anadromous Fish
Pelagic Fish
Freshwater Fish
Bottom Fish
Shellfish
Seaweed/Kelp



n
194
196
173
163
201
116

(^••OTVMBMBBimM
Total
Purchased
Seafood
55%
95%
79%
83%
88%
97%
Purchased
**m******mmimammmm
Groceries
/Street
Vendors
69%
77%
62%
61%
67%
81%
I^BB^BBUBBBBHqMRBVIMBH
Restaurants

16%
16%
17%
22%
21%
16%

Total
Harvested
Seafood
16%
7%
21%
17%
11%
3%
Harvested
Caught in
King County,
Washington
7%
4%
15%
8%
9%
3%
J
Caught
outside King
County, WA.
9%
3%
6%
9%
2%
0% _
E. SEAFOOD SPECIES AND  PARTS  CONSUMED
1.  Seafood species consumed

The percentage of survey participants who consumed each finfish species,
shellfish species, and seaweed/kelp are listed in Appendix K. Salmon and
tuna were the most frequently consumed finfish. Of the shellfish species,
more than 75% of respondents consumed shrimp, crab, and squid. Appendix
M-l lists the percentage of survey participants consuming "miscellaneous
seafood/'  These seafood were identified when participants were asked if there
were "other seafoods which you eat that were not mentioned earlier" (in the
questionnaire). The most frequently consumed miscellaneous seafood was
the octopus (11%).  This low percentage suggests that information provided by
the Community Steering Committee provided accurate guidance for reducing
the number of species  questions on the questionnaire.
API Seafood Consumption Study
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 2.  Seafood parts consumed

 For all survey participants, when finfish were eaten, the head, bones, eggs,
 and other organs were consumed twenty percent (20%) of the time.
 (Table R-8).  Fillet with skin was eaten 55% of the time. Forty-two percent of
 the respondents reported they eat fillet with skin "sometimes" (more than  0%
 but less than 100% of the time) and 30% "always" (i.e. 100%) eat fillet with
 skin. Thirty-six percent reported they "sometimes" eat head, bone, eggs,
 and/or organs, and 8% said they "always" eat head, bones, eggs, and organs.
 However, the consumption pattern of fish parts was not uniform among the
 ten ethnic groups. Vietnamese, Hmong, and Mien reported eating the fillet
 with skin a greater percentage of the time than other API ethnic groups.
 Caution should be exercised when using these data to describe habits by ethnic
 group because of the small numbers surveyed.

 TABLE R-8. PARTS OF FINFISH CONSUMED BY ETHNICITY
••
Cambodian
Chinese
Filipino
Japanese
Korean
Laotian
Mien
Hmong
Samoan
Vietnamese
All Ethnicity
••
20
30
29
29
15
18
9
5
10
25
190
Fillet with skin
64%
55%
59%
30%
50%
42%
67%
100%
45%
78%
55%
Fillet without skin
36%
45%
41%
70%
50%
58%
33%
0%
55%
22%
45%
Head, bones, eggs, organs
34%
27%
26%
10%
1%
4%
23%
90%
11%
18%
20%
The consumption pattern of shellfish parts varied depending on the specific
shellfish (Tables R-9 and R-10). Most of the time, clams were eaten without
removing the stomach. For example, manila/littleneck clams were eaten only
10% of the time with the stomach removed. Sixty-three percent of the time
macoma clams were eaten whole. This clam ingests sediment and does not
filter feed like littleneck clams. Crabs were eaten whole (includes the meat
and hepatopancreas) 43% of the time.
    Seafood Consumption Study
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  TABLE R-9.  SHELLFISH CONSUMPTION (BIVALVES)
m^;'ftv;V^^
Shellfish


Maniia/littleneck clams
Oysters
Mussels
Scallops
Butter clams
Geoduck clams
Cockles
Razor clams
Abalones
Horse clams
Macoma clams
•nHHHH|
I i on 5i i mprQ
V_- U 11O U L 1 It 1 .3
72% (145)
71% (142)
62% (125)
57% (115)
39% (78)
34% (68)
21% (42)
16% (33)
15% (30)
13% (27)
9% (1 9)
PJUIHH
|
i
77%
88%
89%
71%
76%
24%
64%
58%
53%
48%
63%
•E933D9HB
wYstomach > 'Sip
removed |
10%
5%
6%
4%
14%
40%
12%
21%
23%
22%
26%
3J3BHES1
hon removed

4%
4%
4%
1%
3%
2%
9%
0%
2%
0%
0%

Whole with
stomach and
siphon removed
9%
3%
1%
24%
6%
35%
14%
21% !
22%
30%
11%
 TABLE R-10 NON-BIVALVE SHELLFISH CONSUMPTION
;: , Species ;
Shrimps
Crabs
Squids
Lobsters
Sea Cucumbers
Sea Urchins
Moon snails
% Consumers v
(n)
98% (196)
96% (192)
82% (165)
65% (131)
15% (31)
14% (29)
4% (8)
Whole
21%
43%
22%
16%
26%
24%
38%
Body/meat/ ;
eggs/ :' !:
muscles only
78%
57%
78%
84%
74%
76%
62%
Tissue parts consumed
-.':-:; ./•:••:' ', .'• .'.<". : '. •' .'.. '. '•"'
body and head versus meat only
crab meat and butter* versus meat only
whole squid versus body and tentacles only
whole body and head versus body only
whole body versus muscle only
whole body versus eggs only
whole body versus muscle only __
       *The "butter" a crab is defined as yellowish liquid and soft tissue compromised of the cooked
       gastrointestinal tract which includes the hepatopancreas and stomach.

F. PREPARATION METHODS

The survey covered two categories of preparation methods (Table R-ll):
"baked, boiled, broiled, roasted, or poached," and "canned, fried, raw, smoked,
or dried." The respondents reported that they prepared both finfish and
shellfish more often using the method of  "baked, boiled, broiled, roasted, or
poached," averaging 65% and 78% of the time, respectively. The second
method of "canned,  fried, raw, smoked, or dried," was also used substantially
in the API community, ranging from 35% for finfish and 22% for shellfish.
API Seafood Consumption Study
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1 TABLE R- II FISH PREPARATION METHODS
Finfish
^^^^—

\
Baked, boiled,
broiled, roasted,
i or poached
Cambodian 20 54%
Chinese 30 79%
Filipino 30 58%
Japanese 29 78%
Korean 15 57%
Laotian 19 59%
Mien 8 74%
Hmong 5 50%
Samoan 10 52%
Vietnamese 25 67%
All Ethnicity 191 65%
Canned, fried,
raw, smoked, or
dried r
Shellfish
Baked, boiled,
broiled, roasted,
i or poached
46% 20 65%
21% 30 82%
42% 30 77%
22% 29 68%
42% 15 89%
41% 19 79%
26% 8 88%
50% 5 60%
48% 10 50%
Canned, fried,
raw, smoked, or
dried
35%
18%
. 23%
32%
11%
16%
13%
40%
50%
33% 25 92% 8%
35% 200 78%
22%
VVhen finfish were prepared (Table R-12) with boiling, 33% of the time the
boiled water was thrown out, and 54% of the time the boiled water was re-
used either in cooking (36%) or simply in drinking (18%). Boiled water in
preparing shellfish was thrown out at a rate of 57% of the time. The re-use of
the boiled water in preparing shellfish was evenly distributed between
"drinking" and "cooking," at a rate of 21% of the time.  Mien and Hmong
survey participants drank the cooking water from both finfish and shellfish a
survey higher percentage of the time.

TABLE R-12. SEAFOOD COOKING WATER USAGE (PERCENTAGE OF TIME USED)
Finfish: Water Usac
^^^—
n
Cambodian
Chinese
Filipino
Japanese
Korean
Laotian
Mien
Hmong
Samoan
Vietnamese
All Ethnicity
20
30
30
29
22
20
10
5
10
26
202
Throw Out
18%
58%
47%
41%
19%
14%
28%
0%
60%
12%
33%
Use in
Cooking
67%
15%
20%
38%
45%
31%
0%
0%
23%
80%
36%
]e* Shellfish
. Drink It
0%
42%
34%
0%
0%
3%
62%
100%
27%
0%
18%
Throw Out
88%
68%
46%
52%
31%
74%
38%
0%
73%
60%
57%
: Water lisa
Use in
Cooking
13%
15%
24%
11%
51%
10%
0%
0% .
16%
36%
21%
ae*
Drink It
0%
39%
30%
32%
5%
3%
53%
80%
14%
0%
21%
      *Mean percentage.
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  G.  Re-interviews
  Since the study is a recall survey of the fish consumption, the reliability and
  consistency of the answers provided by the respondents was tested by re-
  interviewing. To assess the reliability of the responses, 20 respondents were
  selected  for a follow-up re-interview via telephone after the completion of
  their survey interviews. A subset of the questions in the survey questionnaire
  were selected and used in the re-interview. These questions were: the
  frequency of consuming salmon, halibut,  shrimps, the sources of
  anadromous fish and shellfish, and the parts of finfish consumed. Since the
  re-interview was conducted by telephone  and no model display was available,
  no questions regarding portion sizes were asked. Re-interviews occurred
  within one to four months after the initial interview. The  interval variation
 was due  to participant recruitment  delays encountered because of specific
 ethnic group, gender, and age requirements.

 The table in Appendix M-10 indicates that substantial difference exists
 between the answers provided by the 20 respondents who participated in the
 re-interview process. This difference in inter-individual paired results
 suggests that consumption rate for  each individual can not be consistently
 estimated. In this study, our focus is to provide an assessment of the seafood
 consumption rate for API community. Table R-13 shows the group results of
 the original survey and the re-interview on the same questions. The
 Wilcoxon ranked test indicates that the answers provided in the original
 survey and  the re-interview were not significantly different for most of the
 re-interview questions, except for the percentage of anadromous  fish caught
 outside King County, Washington (p=0.043), shellfish caught in King County
 (p=0.027), shellfish consumed at  restaurants (p=0.023), and consumption of
 head, bone,  eggs, and organs of finfish (p=0.036). This result suggests that the
 difference in the means between the original and re-interview for all 20
 respondents as a group indicates that the estimated consumption rates for the
 whole API community in this study can be viewed as generally reliable.
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 TABLE R-13 COMPARISON OF ANSWERS BETWEEN ORIGINAL SURVEY AND THE RE-INTERVIEW
r—
• •

Salmon: #of servings per year
Halibut: # of servings per year
Shrimp: # of servings per year
Anadromous fish: purchased from groceries
Anadromous fish: caught in King County
Anadromous fish: caught outside King County
Anadromous fish: eat at restaurants
Shellfish: purchased from groceries
Shellfish: caught in King County
Shellfish: caught outside King County
Shellfish: eat at restaurants
Finfish: fillet with skin
Finfish: fillet without skin
Finfish: head, bone, eggs, organs
Original
mean(SE)

17(4)
6(2)
24(4)
80% (6%)
7% (4%)
4% (3%)
8% (3%)
82% (5%)
6% (3%)
!%(!%)
11% (3%)
53% (9%)
42% (9%)
24% (8%)
Re-Interview
mean(SE)

14(4)
7(2)
41 (16)
76%'(7%)
6% (2%)
9% (4%)
10% (4%)
77% (6%)
0% (0%)
3% (3%)
21% (5%)
44% (8%)
56% (8%)
9% (4%)
Two-sided
••'• p-valua
(Wilcoxon)
0.3
0.9
0.7
0.5
0.7
0.043
0.7
0.4
0.027
0.3
0.023
0.4
0.2
0.036
 H. Educational Outreach Information

 The educational outreach information was evaluated in two ways.  First, by
 educational status (high school or less, n=69; and greater than high school,
 n=98); then by fishing status (fishermen, n=66; and non-fishermen, n=136).
 preferred sources of reliable information about the API community, preferred
 learning methods, and types of information desired about seafood were
 compared for these groups. The fishermen (n=66) were also queried about
 fishing safety information sources.

 Table R-14 shows the most reliable sources of information used by the API
 community by fishing and educational status. There were no  appreciable
 differences based upon fishing or educational status.  Radio in native
 language appealed to relatively few, though radio broadcasts at the time of the
 study were available only in the following languages: Cantonese, Vietnamese,
 Tagalong, Laotian/Mien, Korean, and Samoan and may not have used the
 preferred dialect of the survey participants.  For example, radio in native
 language was deemed reliable by 40% of Mien and 0% of Laotian respondents.
 Radio broadcast in native language was deemed a reliable source of news by
 17% of Chinese, 13% of Filipino, 36% of Korean, 0% of Samoans and 39% of
 Vietnamese.
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 TABLE R-14. BEST/MOST RELIABLE SOURCES OF INFORMATION USED BY THE API COMMUNITY.
   Source of Best/Most Reliable
          Information
Fisherman    Non-    All Survey   HSor
          fisherman  Responde   Less
 (n=66)     (n=136)   nts (n=202)   (n=69)
         thanHS
Community Newspapers/Newsletters
Television
Word of mouth
Temple/mosque/church
Community Center
Radio in English
Radio in own language
Bulletin Boards
85%
64%
65%
36%
30%
29%
24%
11%
70%
66%
60%
37%
28%
28%
13%
19%
75%
65%
62%
37%
29%
28%
16%
16%
70%
64%
54%
39%
38%
25%
28%
22%
82%
64%
68%
36%
26%
32%
11%
15%
 Survey participants were asked to indicate which two of the learning methods
 listed in Table R-15 they preferred. Sixty-one percent of the fishermen and
 74% of non-fishermen preferred learning with the use of books/pamphlets,
 and 55% of all survey respondents preferred listening to someone. Less than
 10% preferred to learn through the use of tape recordings, slide shows, and
 comic book presentations. Findings were similar using the  educational status
 categories.
TABLE R-15. PREFERRED LEARNING METHODS
Preferred Learning Methods    Fisherman
                           (n=66)
         Non-     All Survey
       fisherman   Respondent
        (n=136)    s(n=2Q2)
  HSor
  Less   than HS
 (n=69)    (n=98)
Book/pamphlets
Listen to someone
See video
Learn on Computer
Tape recording
i See slide show
Read comic book
61%
55%
41%
18%
9%
6%
3%
74%
55%
32%
15%
7%
3%
5%
69%
55% '
35%
16%
8%
4%
5%
58%
51%
44%
13%
16%
6%
9%
74%
55%
32%
15%
2%
4%
3%
Survey participants were asked to indicate what information about seafood
would be of interest to them (Table R-16).  Most participants wanted health
information about eating fish (82%) as well as the safety of Puget Sound
seafood (69%). Somewhat fewer fishermen wanted information about safe
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 preparation methods compared to non-fishermen (58% versus 72%,
 respectively), and more fishermen than non-fishermen wanted  information
 about safety of specific fishing location in Puget Sound.
TABLE R-16. PREFERRED SEAFOOD INFORMATION
  Information Desired About Seafood    Fishermen
                                 (n=66)
        Non-     All Survey
      fishermen  Respondents
       (n=136)     (n=202)
       HSor
                                                                         thanHS
       (n=69)   (n=98)
Health info about eating fish

Safety of Puget Sound Seafood
Safe preparation information
Safety of specific fishing locations in PS
Type/amounts of Seafood eaten by API's
83%

73%
58%
53%
33%
817o

67%
72%
29%
27%
82%

69%
67%
37%
29%
78%

71%
64%
33%
29%
86%

69%
69% >
38%
32%
Fishermen were asked to cite useful information sources to find out about the
safety of fishing in a particular site (Table R-17).  Word of mouth (65%) was
the most frequently cited useful information source followed by posted
warning signs (59%). Less than one-half found State and County sources
useful. More fishermen with >HS education indicated that posted warning
signs, Washington State Shellfish Information, and the red tide hotline are
useful information sources  than those with  
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 V. EDUCATION AND COMMUNICATION OF STUDY FINDINGS (PHASE III)

 A. METHODS

 1. Introduction

 Phase III of the Seafood Consumption Study was intended to serve as a
 vehicle to develop and field test culturally appropriate educational materials
 to convey information about seafood. While Phase II described and
 quantitated seafood acquisition, consumption, and preparation habits, such
 technical information obtained in Phase II is more useful to the regulatory
 agencies and risk assessors than the API community. Community leaders
 indicated that the quantitative information was of little interest to them, and
 among survey respondents, only 29% of indicated that they would like to
 know the amount of the fish that was consumed by API community.
 However, 82% of survey respondents desired health information about eating
 fish, 68% information about safety of Puget Sound seafood, and 67%
 information about safe seafood preparation methods.  Therefore, a strategy
 was developed to link the technical expertise of the Advisory and Technical
 Committees with the  cultural perspectives of the Community Steering
 Committee to develop health messages  for the API community about seafood
 related health issues, safe acquisition information, and safe preparation
 methods.

 These efforts resulted  in a draft brochure that was translated into ten
 languages and focus group tested. Based  upon comments from community
 focus group reviewers, and the Advisory  and Technical Committee members,
 modification of the English version of the educational materials was
 accomplished. Funding for the pilot translation was available, but not to
 finalize the translation or distribute the brochure.

2.  Selection of an Education/Communication Tool

The original study design called for the development  of a slide show;
however, this idea, with concurrence from the U.S. EPA  grant manager, was
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 discarded for several reasons. First, data collected from the Phase II study
 survey (see table R-12) showed that only 4% of survey participants considered
 slide shows a preferred learning method while 69% preferred books or
 pamphlets.  Secondly, members of the Community Steering Committee
 indicated to the RFSC Study Coordinator that they preferred brochures
 because they are easier to distribute than slide shows and can be referred to as
 reference material over a longer period of time.  They also felt that translators
 are more willing to translate a pamphlet than a slide show and that slide
 shows are considered "old technology" with videos being preferred, however
 the cost of video production was not covered by the grant funding.

 3. Development of Education/Communication  Tool

 The UW asked members of the Technical and Advisory Committees  to
 brainstorm and  name five most important public health risks associated with
 seafood consumption and acquisition. Eight of  the fourteen committee
 members (both committees combined) responded by identifying fifteen
 general concerns. These were ranked by citation frequency. From this list,
 CSC members (n=16) were then asked to select five concerns they felt  to be
 most important  for the API community (Appendix N-l). The goal was to
 incorporate the  top five health messages into the brochure; however, seven
 were ultimately  included because  three health messages received  the same
 rating from the CSC for the fifth position. The CSC was concerned about the
 issue of "seafood from foreign markets and restaurants", but this was not
 included because of the topic's complexity and scope.

 Using these topics,  the UW developed the text (health and preventive
 behavior messages) of the brochure, which then was edited by the RFSC Study
 Coordinator.  The CSC reviewed these messages to ensure cultural
 appropriateness  and understandability. The UW and the RFSC also
developed a list  of resources for obtaining further information (e.g., Red Tide
Hotline, etc.) to include in the brochure.  The resources included were based
jn part on recommendations made by members  of the Technical and
Advisory  committees, and the SC.
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  Other sources of community input included discussion with the director of
  the Seafood Consumption Information Project with Save San Francisco Bay
  Association, to advise in the planning and development of the educational
  brochure. The San Francisco project had also developed an educational
  brochure to raise awareness of safe cooking preparations, sensitive
  populations, etc. The SC also met with the director of the Wilderness-Inner
  City Leadership Development Youth Programs of the International District
  Housing Alliance in Seattle, Washington, to exchange strategy and
  development ideas since that organization was also in the midst of
  developing an educational brochure on seafood consumption.

  From the acquired information, the RFSC Study Coordinator developed a
  basic layout for the brochure that was transformed into a brochure format by a
  graphic artist with the U.S. EPA Region X (Appendix N-2).

 4.  Translation and Focus Group Testing

 RFSC Study Coordinator recruited ten translators from the community to
 translate the brochure. Translators were required to be bilingual in English
 and one of ten languages: Cambodian, Chinese, Filipino, Japanese, Laotian,
 Korean, Hmong, Mien,  Samoan, and Vietnamese.

 RFSC study coordinator recruited eight focus group members from the API
 community to review the brochure (both English and translated version) for
 format, content, translation, and presentation; each  was compensated with
 $25. Focus group members were recruited from health clinics, educational
 institutions, libraries, and community organizations. Due to unexpected and
 unavoidable time conflicts experienced by the RFSC study coordinator, focus
 group members from the Hmong and Samoan communities were not
 recruited. For the same reason, the focus group did not meet as a whole
 group;  rather, members completed a self-administered questionnaire
 (Appendix N-3) which evaluated the content, accuracy of translation,
 effectiveness, and format of the brochure.

 RFSC Study Coordinator also mailed the English brochure translation to the
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 Technical, Advisory, and Community Steering Committees for their general.
 comments and recommendations.

 Comments and recommendations from the Focus Group, Technical,
 Advisory, and Community Steering Committees, as well as other interested
 parties were incorporated into the English translation of the educational
 brochure. Translation of the final edited version was outside the scope of the
 grant study plan.


 VI  Results  (Phase III)

 Overall, with the exception of the Mien review, the health risk messages,
 graphics, and effectiveness of the brochure were rated, generally, good to
 excellent by the focus group reviewers (see Appendix N-4). The brochure was
 felt to be useful for decision making.  Except for Laotian and Mien
 translations,  the translations were above average, and the presentation clear
 and precise.  Reviewers made corrections to translation on the brochures
 themselves (see Appendix N-5), which will be useful when the final version
 of the brochure is published (funding to be obtained).

 Comments from the focus group reviews, the CSC, the Technical and
 Advisory Committees, as well as other interested parties, were incorporated
 into the brochure where appropriate.  An English version of the brochure,
 which incorporated all of the editorial comments, is contained in (Appendix
 N-6).

 DISCUSSION

 PARTICIPATION RATES
   expected, participation rates among volunteers were high (96%), and
somewhat lower in the roster group (67%). Within the roster group, 67%
elected to participate. Reasons for refusal are unclear. Though community
leaders were involved  through membership on the Community Steering
Committee and urged community organizations to participate, they were not
involved in person to person recruitment. Chiang (1998) achieved a 79.8%
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 participation rate in her study of the Laotian community, which was made_up
 of the following ethnic groups: Khmu (13%), Laotian (32%), Mein (45%), and
 Thadum (10%).  Her success may reflect community leader involvement; e.g.
 they made first contact with all study participants. In addition, Chiang's study
 focused on only one ethnic community which happened to be closely knit,
 unlike the  King County study  which targeted ten groups which were
 dispersed throughout the area. The roster method of recruitment also had
 the drawback that churches and community groups may not have resources
 to update their membership rosters.  Interviewers were unable to contact 54%
 of the individuals selected for  interview. Despite the differing participation
 rates between the volunteer and roster groups, the seafood consumption rates
 between the two groups did not differ significantly.


 POTENTIAL  BIASES

 This study covers ten  ethnic groups in the Asian and Pacific Islander
 community who reside in a large metropolitan, area. A complete numeration
 and  a random sampling of the  targeted population was not feasible. To reduce
 potential coverage bias in the recruitment of respondents, a two-tier approach
 was  employed by the  study team - "roster" and "volunteer" selection. This
 two-tier approach may not be theoretically  optimal for the coverage and
 selection of an unbiased sample of the targeted population; it was designed to
 minimize possible bias in the selection of respondents.

 While the study team  made every effort in  soliciting  as many rosters  as
 possible from organizations in the API community,  nevertheless, some
 organizations in the API community refused to share their membership
 rosters with the study team. Reasons generally involved confidentiality
 concerns. It is difficult to assess what bias, if any, exists by using the roster lists
 provided by the community organizations.

 The survey was advertised as a "dietary habits study" to reduce the possibility
 that potential lower seafood consuming participants would de-select
 themselves. It is difficult to determine this strategy's success because an
 undetermined number of the community members were aware that a
seafood consumption study had been funded  for Phase I (completed in 1996).

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 This bias would be expected to be most evident within the volunteer group	
 which represented individuals who actively volunteered for the study versus
 the roster group which was randomly selected from preexisting lists. This
 effect, if present, is probably small because comparison of roster and volunteer
 consumption rates showed no significant difference between these two
 groups.

 Thirty-eight percent of survey participants who responded to questions about
 their income (n=187) lived below the Federal Poverty Limit (FPL). These rates
 are also considerably higher than the 14.8% observed among all API's residing
 in King County in 1990 (1990 U.S. Census). This difference may be due to the
 recent immigration status of the study group when compared to the
 multigenerational composition of API's in King County, or economic
 patterns shifting since the  1990 census. The relatively high percentage of
 individuals living below the FPL also may have been influenced by
 calculation procedures. Because income was considered a culturally sensitive
 question, survey respondents were asked to check income range categories
 instead of providing exact income information. Calculation of FPL used the
 midpoint of the range, e.g. $5000 for survey participants who marked the $0  -
 $10,000 income level.  This method may have underestimated incomes.

 A slightly greater percentage of the roster than volunteer respondents
 interviewed  in this study were living under the federal poverty level (39%
 versus 32%,  respectively), but roster participants were not more likely than
 volunteers to be first generation.   People.in the lowest income level (under
 FPL) ate more in the categories of all seafood, all fish, and shellfish, but none
 of the differences were statistically significant. First generation consumed
 significantly more freshwater fish and shellfish than second generation
 participants.

 The impact of the relatively more low-income respondents in the  study may
 not warrant  major concern. The results of this study have indicated that there
 vvas no significant difference among the income levels in terms of overall
 fish consumption rates among the API community, and income was not
 related to "fishermen" status. Respondents in the "more-established" ethnic
 Croups (for example, Japanese,  Chinese, Filipino, Korean) seemed to consume

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 more fish by purchasing from groceries/street vendors and restaurants, the
 other groups reported more self-harvested fish for consumption.

 The reliability of participant responses was assessed using a subset of 14
 questions from the survey. Of these, 3 queried seafood consumption
 frequency, 3 tissue parts consumed, and 8 source of seafood. The retest of ten
 questions showed no significant response differences and that responses were
 generally reliable. Two of the four questions for which answers differed
 significantly were related to fishing locations.  During face-to-face interviews
 a map visually clarified the definition of "inside Puget Sound" versus
 "outside Puget Sound" to be "inside" versus "outside" of King County. Such
 visual clarification could not  be accomplished via telephone interview, and
 without the map, misinterpretation was likely because  Puget Sound, while
 within King County,  is much more extensive then just King County,
 Washington. The other two questions were source of shellfish (restaurants)
 and finfish tissue parts consumed (head, bone, eggs, organs). Reasons for
 these differences are unclear.

 PER CAPITA CONSUMPTION ESTIMATION

 This study was designed to quantitate usual intake among API seafood
 consumers. Because participants had to be seafood consumers, the study was
 not designed to determine per capita rates; so the percentage of non-
 consumers were estimated from  interviewer screening logs. The study
 recruitment protocol required that prospective participants answer a series of
 qualifying questions; e.g., their county of residence, ethnic group, age,
 generation in the U.S., and seafood consumption status.  Of all prospective
 participants willing to participate in the study, only 1.5% were disqualified
 because they did not eat seafood, 0% in the volunteer group, and 2% in the
 roster group. These data suggest that seafood  consumption is almost
 universal within the API community and that per capita rates are probably
 similar to those calculated here. Chiang (1998) also did  not quantitate the
 number of non-consumers, but found that 87% of the Laotian community
surveyed in West Contra Costa County, California, ate seafood at least one
 time per month. A survey of 500 Native Americans  from the Umatilla, Nez
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 Perce, Yakima, and Warm Springs tribes found that -9% did not consume
 fish (CRITFC, 1994).

 CONSUMPTION RATES
 This study was intended to evaluate the fish consumption rates of the API
 community members in King County, Washington. The 202 respondents
 were from ten different ethnic groups. While the observed consumption rates
 have been reported for each ethnic group in this study, it is important to note
 that the estimate of consumption rate for any specific ethnic group should not
 be considered accurate because of the small sample size for the individual
 ethnic groups.

 The median seafood consumption rate was 89g/day for the average weight
 (62kg) of all survey participants.  A consistent difference was noted between
 mean and  median seafood consumption rates. As discussed above, this
 difference  persisted even when consumption rates for the highest consumers
 (outliers) were corrected to 3 standard deviations above the mean. These data
 suggest that there are APIs who have very high rates of seafood consumption.
 For example, consumption at the 90th percentile rate would be 242g/day or 7.8
 ounces seafood per day. Even at the 10th percentile, consumption was 32g/day
 which is above the 21g/day per capita rate estimated by Javitz (1980). The API
 ethnic groups with  the highest seafood consumption rates were Vietnamese
 (median: 148g/day) and Japanese (median: 113g/day).

 These high rates may be explained by the more recent immigration status of
 g9% of participants and possibly the lower income status of many participants,
 though the higher fish consumption rates observed in  the lowest income
 group were not statistically significant. There are no published studies
 available which estimate seafood consumption rates in API countries of
 origin, e.g.  Japan, China, etc.

 Survey methods may also overestimate consumption rates. Our survey
 specifically queried "in" and "out of season" consumption  rates for a total of
40 finfish and shellfish species, and participants could add  additional species if
consumed.  Several models were used for species types as outlined in the
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  methods. Multiple estimations of consumption by a single respondent may
  overestimate consumption rates. The timing of survey administration
  (Spring and Fall) may have influenced consumption reporting for certain
  species, however, the survey was structured to query seafood consumption
  both "in" and "out" of season.

  In contrast, Chiang found markedly lower consumption rates (median
 9.2g/day) in the Laotian immigrant population in California. This may reflect
 several factors.  First, there is a high-profile Superfund site which has
 contaminated the Bay near this community, and  the lower consumption rates
 may reflect the effectiveness of the public awareness program regarding
 contaminated fish  in local waters.  Second,  survey instrument differences
 may account for some of the disparity. In Chiang's survey, a single model was
 used to estimate usual seafood portion size  for both finfish and shellfish
 species together, and then grouped usual consumption frequencies into
 imprecise categories(e.g. more than once/day, 3-4  times/week, a few times a
 month, etc), which may have resulted in consumption rate underestimation.
 Finally, our study used models portraying uncooked weights except for crab
 and bivalve shellfish, whereas Chiang referred to cooked weight.  Jacobs
 (1998) indicates that an uncooked fish portion is -22%  heavier than cooked
 fish.

 Studies, using similarly structured questionnaires  to that in our study, of
 Pacific Northwest Native Americans who fish for subsistence have also
 documented high rates of fish consumption. Men in the Tulalip  and Squaxin
 Island Tribes (Toy, 1995) consumed a median of 53  g/day and 66 g/day for the
 two tribes respectively, while women consumed a  median rate of 34 g/day
 and 25 g/day. Among the Umatilla, Nez Perce, Yakama and Warm Springs
 Tribes of the Columbia River Basin, median seafood consumption was 40
 gram/d among tribal members who eat fish (mean=63g/d), and 32 g/d (mean
 =58.7g/d) among all tribal members (n=500).  Easy access to marine waters as
 well as fresh water may account for the higher consumption rates among the
Tulalip and Squaxin Island Tribes.
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 SEAFOOD SOURCES

 Our study showed that the majority of seafood is obtained at grocery stores,
 street vendors, or from restaurants, with harvesting by self, family or friend
 being used less often. While these numbers appear to suggest that the
 majority of seafood consumed is from "commercial" sources, locally caught
 fish, possibility from contaminated sources, may be sold by vendors trying to
 cut costs. Chiang's study suggests that smaller markets and street vendors may
 be the source of a large percentage of seafood. She reported that 50% of the
 Laotian community used large markets (e.g., Lucky, Costco, Safeway), 57%
 small markets, 55% a fisher person/fish truck/farmer's market, and 54%
 harvested (self/family/friend).

 In our study, harvested seafood  comprised less  than one quarter of the total
 consumption; nevertheless, differences were observed among the ethnic
 groups. Members of the Mien community seem to harvest seafood more
 often than other ethnic groups. The percentage of time Miens consumed
 harvested fish were: 100% for bottom fish, 84%  for freshwater fish, 54% for
 anadromous fish, 35% for pelagic fish, and 34% for shellfish.  However their
 total seafood consumption was the lowest of all surveyed ethnic groups.
 Cultural traditions may play a role because Miens immigrated from the rural
 highland areas of Laos (Gilrnan, 1992) where harvested fish may have not
 been readily available and therefore consumption might not be as customary.
 In addition, 60% of Mien participants lived below the FPL. Even though the
 Mien community does not consume as much seafood as  other APIs, they may
 have greater risks for seafood contaminant exposure because they harvest
 more for subsistence. Chiang's study determined the number of fishermen
 (n=95) and their main reason for fishing, of whom 53% fished  "for food"
 compared with 37% for "recreation", 1% for "traditional" reasons, and 10%
 "no answer".  Despite the small  sample size, these pilot data warrant follow-
 up study.

 SEAFOOD SPECIES AND TISSUE PARTS CONSUMED
 APIs consume a wide variety of  seafood species, the most frequently
consumed being shellfish.  These seafood, depending on their  feeding and
habitat characteristics, and the tissue parts consumed pose varying chemical

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 contaminant risks to APIs. For example, certain fat soluble chemicals, e.g.
 PCB's are concentrated in the fat layer between the meat and skin, potentially
 exposing such consumers to higher contaminant levels than those who
 simply eat the fillet. Eating the fillet with skin is clearly a common practice in
 the API community.  Chiang (1998) determined that of Laotian community
 members who had ever fished in San Francisco Bay (n=88), 76% "always" ate
 the fillet with skin, 23% "sometimes" ate the skin, and 1% "never" ate the
 skin. Among all our study participants 30% "always" ate the fillet with skin,
 42% "sometimes", and 28% "never". Overall, skin was consumed with the
 fillet 55% of the time. Consumption of fillet with skin appeared to vary with
 ethnicity, but  interpretation is difficult because of the small numbers. Among
 the Hmong (n=5), Vietnamese (n=25), and Mien (n=9), and Laotian (n=20) the
 fillet with skin was consumed 100%, 78%, 67%, and 42% of the time,
 respectively.

 In addition to concern about consuming fillets with skin, information about
 contaminant levels in other fish tissues may be insufficient for culturally
 appropriate risk assessment (e.g., head, bone, eggs, and/or organs) because risk
 assessors have not felt that they are commonly eaten.  In this study, these
 parts were eaten 20% of the time, (8% said they "always", and 36%  reported
 they "sometimes" eat head, bone, eggs, and/or organs).  Unfortunately our
 data cannot determine which of these body parts are eaten more frequently.
 Salmon eggs were consumed by 27% of participants, and other types of fish
 eggs by 10%. This is similar to Chiang's findings that 'organs' were "always"
 consumed by 6% and  "sometimes" consumed by 41%. Wong (1997) found
 that 98% of 228 mixed race fishermen residing near San Francisco Bay (36%
 Asian, 24% Caucasian, 14% Latino, 12% African American, 7% mixed  race, 2%
 Pacific Islander) consumed 'non-fillet parts' (e.g., skin, eggs, heads, guts) when
 perch was eaten. Similar rates were found for striped bass (84%) and white
 croaker  (77%).

 API community members appear to eat shellfish parts that are thought to
 contain  higher concentrations of chemical contamination, e.g. clam stomachs
 or the hepatopancreas of crabs (Faigenblum, 1988; Matter, 1994). Bivalve
shellfish were consumed whole by 24% (geoduck) to 89% (mussels) of the
 respondents depending on the species.  The "butter" as well as the  meat of

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 crabs were consumed 43% of the time, and though moon snails are not eaten
 by most respondents, 38% of the time the entire moonsnail is eaten. Finally,
 cooking water, both for finfish and shellfish are commonly used in cooking
 or directly consumed.

 Cost considerations frequently preclude chemical contaminant analyses for
 these tissues. Certainly for the API's, seafood related risk assessment should
 include chemical analyses of all consumed tissue parts for the most frequently
 consumed species. For instance, crabs were commonly consumed (96% of
 API's), and 43% of the time the "butter" of the crab, including the
 hepatopancreas was consumed. Selection of seafood species and tissue part
 contaminant testing should reflect the cultural consumption habits of specific
 "at risk" populations.

 FISHERMEN

 Fishermen have been reported (Allen 1996, Puffer 1982, Wong 1997) to
 consume greater quantities of fish than non-fishermen.  These data are
 generally derived from creel studies and may have surveyed biased groups,
 e.g. the "10% of fishermen who catch 90% of the fish".  Our study was not
 advertised as a fish consumption study and was expected to have captured a
 cross-section of fishermen. So, while  this study showed that fishermen
 consumed greater quantities of seafood than non-fishermen  in all seafood
 categories, these differences were not significant. In addition, the  "higher"
 consumers (individuals who had seafood consumption rates >75th percentile
 for finfish or shellfish) were no more  likely to be fishermen  than those with
 lower consumption rates.  Decreased opportunity for fishing is an unlikely
 reason because King County, Washington's geographic proximity to Puget
 Sound and multiple lakes and rivers, which provide easy access to fresh and
 salt water fishing and shellfish collection both in urban (assessable by public
 transportation) and rural settings. This observation may be explained by
 cultural traditions which incorporate seafood into daily diets of most first and
 second generation API's.
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 EDUCATIONAL OUTREACH INFORMATION

 Many recent API immigrants are refugees from war torn countries and
 understandably distrust government officials or those in authority.  Some
 local efforts to establish communication with APIs have emphasized active
 support and involvement of local API community service organization, as
 well as information conveyance through API  community members and
 organizations (Clifford,  1998; Tebaldi, 1999).

 Our survey examined the educational preferences and fishing information
 sources of APIs. Respondents expressed a preference for written material as a
 way of learning. The preferred media were API community
 newspapers/newsletters, while bulletin boards were deemed reliable by only
 16% of respondents. Audio-visual communication; e.g. television and word
 of mouth were also preferred, but videos (35%) and slide shows (4%) were less
 favored.  Radio broadcasts in API languages were used by a  relatively small
 percentage (16%), but multiple dialects may be a factor, and for specific groups
 may be effective. Wong (1997) successfully used both a seafood cooking
 demonstration and pamphlet to educate children and adults about
 minimizing exposures to chemically contaminated San Francisco Bay fish.

 The API  respondents were very concerned about health.  They wanted health
 information about eating fish, as well as safety information about Puget
 Sound seafood. Very few fishermen said they were not concerned about the
 safety of fish (6%) or that they never try to find out about fishing safety (3%).
 Among fishermen, fishing  safety information is mainly obtained by word of
 mouth (65%) and posted warning signs (59%). Education beyond high school
 appeared to play a positive role  in utilization of posted warning signs,
 pamphlets, and telephone  information services, e.g.  Washington State
 shellfish  information and Red Tide Hotline. Information from API
 community centers and API radio broadcast were more frequently deemed
 reliable by those with < high school, and may be effective for disseminating
 information  to specific groups.
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CONCLUSIONS

API community members consume greater amounts of seafood, as well as
differing species and tissue parts than the majority of U.S. citizens and
residents. These consumption patterns, while having significant general
health benefits, may pose a health risk if consumed seafood is contaminated
with toxic chemicals. Evaluation of existing seafood toxicity data is warranted
to determine if sufficient data exist for the  tissue parts described in this report.

API-specific risk assessments that take into account these higher consumption
rates, species consumed, tissue parts consumed, and the sources of seafood
acquisition need to be completed. API-specific risk assessments will help the
API community determine if a risk exists,  what activities increase risk, and
which community members have the highest risk.  Such an analysis should
also focus on the benefits of consuming seafood and on culturally acceptable
ways of reducing what risks may exist. Health messages should be designed
and delivered by API community members (including those of  the first
generation who may have  the highest risks) through partnership
relationships with public health agencies.

The ethnic group specific data generated in this study is useful to identify
information needs, but it is based upon  relatively small group numbers.  It
should be used with caution for regulatory or risk assessment purposes
without additional verification.  Further study of API community seafood
acquisition habits, specific  tissue parts consumed, and preparation methods
are important, particularly for members of the Hmong, Laotian, Mien and
Vietnamese communities because our pilot data suggest that they may have
higher health  risks if seafood is contaminated with toxic chemicals.
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  ACKNOWLEDGMENTS

       This study would not have been possible without the generosity of the
  Cambodian, Chinese, Filipino, Hmong, Japanese, Korean, Laotion, Mien,
  Samoan, and Vietnamese communities.  We especially thank the participants
  from these communities for their willingness to provide the authors with the
  data needed to understand how Asian and Pacific Islanders acquire, prepare,
  and consume seafood. Their contributions to this study has provided
  invaluable information for their respective communities, the scientific
  community, and the community at large.

       The collaboration between the Community Steering Committee (CSC)
  and the authors was a groundbreaking experience.  Without the CSC
  members' time and effort, this study would not have materialized.
  Moreover, their knowledge and experience of the communities of focus,  as
  well as their advice on interviewing strategies and  communication tools,
  assured a positive outcome for all involved.  We are most grateful for their
 contributions to this study.

 Community Steering Committee
 Ms. Bee Chang, Hmpng community
 Mr. Chanthone Chin,  Program Coordinator, The Coalition of Lao Mutual
    Assistance Association of Washington State
 Ms. Regina Chae, Korean community
 Mr. Paul Egashira, Japanese community
 Mr. Ngy Hul, President, Khmer Community of Seattle-King County; Acting
    Executive Director, Refugee Federation Service Center
 Mr. Nisay Nuth, Program Coordinator, Khmer Community of Seattle King
    County
 Ms. Luningning Murro, Filipino community
 Mr. Edwin Obras, Director of Development Operational Emergency Center
 Mr. Stan Shikuma, Japanese community
 Ms. Oanh Tran, Case Manager, Refugee Federation Service Center
 Mr. Simon Truong, Social Services Director, Refugee Federation Service
    Center; President, Indochina Chinese Refugee Association
 Mr. Yaochien Sirisisangpha, Case Manager, Refugee Federation Service
    Center
 Ms. Lynna Song, Seattle-Washington State Korean Association
 Mr. Savieng Soukhaphonh, Laotian community
 Ms. May Wong,  Beacon Hill Driving School
 Ms. Benling Wong, Seattle Public Library

      We would like to thank the Taiwanese Association of Seattle for its
endeavors to involve people from Taiwan in the study as a part of the
Chinese community.  We understand that many in  the Taiwanese American
community recognize Taiwan as a separate nation from China, and we

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 respect their position. Our study focused on cultural consumption habits
 only and does not reflect a political position.

       Additionally, we  thank the Fujinkal Association with the Seattle
 Betsuin Temple as well  as other API community religious organizations for
 helping to recruit participants.

       We are grateful to the following scientists and community activists for
 their participation and technical guidance.  We appreciate their expertise as
 well as their concern for populations who may be impacted by environmental
 contaminants.

 Technical Committee
 Dr. Kenneth Chew, Director, Administrative Office, Western Region
    Aquaculture Center
 Mr. Gregory Glass, Environmental Consultant
 Dr. Steven Gilbert, Director, Institute for Neurotoxicology
 Ms. Leslie Keill, Toxicologist, Washington State Department of Ecology
 Dr. Marsha Landolt, Dean and Vice Provost, UW Graduate School
 Dr. Roseanne M. Lorenzana, Toxicologist, US EPA, Region 10
 Mr. Craig McCormack, Senior Toxicologist, Washington State  Department of
    Ecology
 Mr. Jonathan Sheilds, Water Quality Planner, Dept. of Natural Resources
 Dr. Juliet Van Eenwyk, Director, Non-Infectious Conditions Epidemiology,
    Washington State Department of Health

 Advisory Committee
 Dr. Elizabeth Evans, Rainier Center Clinic
 Mr. Joseph Johnson, Boeing
 Ms. Marcia Lagerloef, Water Quality Standards, US EPA, Region 10
 Ms. Roberta Gunn, Executive Director, Puget SoundKeeper Alliance
 Dr. Laura Weiss, Washington State Department of Ecology
 Dr. John Wekell, Research Chemist, US Dept. of Commerce, NOAA

      The interviewers and translators were recruited from the ten
 participating communities.   They provided the vital link in the success of this
 study: obtaining data from the study participants and recording it in a way the
 statisticians could accurately measure.  Their patience and diligence in
 interviewing the participants was remarkable, as was their accurate recording
of data.
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Bilingual Interviewers and Translators
Ms. Helen S. Barber, Filipino interviewer
Ms. Regina Chae, Korean interviewer
Mr. Pang Chang, Hmong interviewer
Mr. Jeff Dang, Vietnamese interviewer
Ms. Alison Doungphouchan, Laotian interviewer
Ms. Chenda Eng, Cambodian translator
Ms. Jeanie Li, Chinese interviewer
Ms. Mia Matsubara, Japanese interviewer/translator
Ms. Luningning Murro,  Filipino translator
Mr. Chet Ouch, Cambodian interviewer
Mr. Ton Saechao, Mien interviewer/translator
Mr. Robert Tausili, Samoan interviewer/translator
Ms. Jenny Wong, Chinese translator

      We thank the University of Washington—National Institute for
Environmental Health Sciences (UW-NIEHS) Center for Ecogenetics and
Environmental Health for providing  technical experts and facilities required
to help bring this study and report to completion.

      This was truly a multi-cultural, multi-disciplinary community study.
Many individuals from the focus communities, Washington State
governmental agencies, grassroots community groups, as well as the
University of Washington, have contributed to the success of this endeavor.
Following are listed those who have  helped us realize this project.

Editor
Ms. Anne B. Harrington, Information Specialist II, UW-NIEHS Center for
      Ecogenetics and Environmental Health

Mr. Michael Antee, Washington State Dept. of Health, Office of Shellfish
   Programs
Ms. Jude Ballard, Fred Hutchinson Cancer Research Center, Seattle, WA
Ms. Audrey Chiang, Asian Pacific Environmental  Network,  Oakland, CA
Ms. Angela Chung, US EPA, Washington, D.C.
Mr. Wayne Clifford, Washington State Dept. of Health,  Office of Shellfish
   Programs
Mr. Floyd Davis, Accountant, Refugee Federation Service Center
Dr. David L. Eaton, Director, UW-NIEHS Center for Ecogenetics and
   Environmental  Health
Ms. Sharon Elliott, Manager, UW-NIEHS Center for Ecogenetics and
   Environmental  Health
Mr. Seng Nguon Eng, Social Services Coordinator, Refugee  Federation
   Service Center
Ms. Joan Hardy, Washington State Dept. of Health, Environmental Health
   Assessment Services

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  The Honorable Gary Locke, Washington State Governor
  Ms. Virginia McFerran, UW-NIEHS Center for Ecogenetics and
     Environmental  Health
  Mr. Christopher Moffett, Graphic Designer, US EPA, Region 10
  Mr. Long Kim Nguyen, President, Vietnamese Association of Greater Seattle
  Dr. Raphael A. Ponce, Research Scientist, UW Department of Environmental
     Health
  Ms. Frances Robinson, UW-NIEHS Center for Ecogenetics and
     Environmental  Health
  Mr. Jim Simmonds, Water Quality Planner II, King County Water and Land
     Resources  Division
  Ms. Yolanda Sinde, Director, Community Coalition for Environmental
     Justice
  Mr. Chin Tan, Case Manager, Refugee Federation Service Center
  The Honorable Kip Tokuda, Washington State Representative
  Doc Thompson, Manchester Lab, US EPA, Region 10
  Dr. Margaret Tudor, Washington State Department of Fish and Wildlife
     Ecosystem Education
  The Honorable Velma  Veloria, Washington State Representative
  Ms. Kristine Wong, Community Coalition for Environmental Justice
  Ms. Cissie Van, Administrative Assistant, Indochina Chinese Refugee
    Association
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  REFERENCES

  Allen JM, Velez PV, Diehl DW, McFadden SE, Kelsh M (1996). Demographic variability
        in seafood consumption rates among recreational anglers of Santa Monica Bay,
        California, in 1991-1992. Fishery Bulletin. 94:597-610

  Bloom, NS (1992). On the chemical form of mercury in edible fish and marine invertebrate
        tissue. CanJ. FishAquatSci,49, 1010-1017

  CRITFC (Columbia River Inter-Tribal Fish Commission). 1994. A Fish Consumption
        Survey of the Umatilla, Nez Perce, Yakama, and Warm Springs Tribes of the
        Columbia River.Basin CRITFC Technical Report 94-3. Portland, Oregon.

 Chiang A, A Seafood Consumption Survey of the Laotian Community of West Contra
        Cost County, California. Asian Pacific Environmental Network, March 1998.

 Clean Water Act, Section 304 (a). Appendix C - Guidelines and methodology used in the
        preparation of health effects assessment chapters of the consent decree water criteria
        document, 45 FR 79347, November 28, 1980.

 Clifford W. (1998) "Barriers to Reducing High Risk Recreational Shellfish Harvesting",
       conference presentation at the 5th Annual Joint Conference on Health, Yakima,
       Washington.

 Faigenblum J (1988). Chemicals and Bacteriological Organisms in Recreational Shellfish;
       Final Report Co-operative Agreement; U.S. EPA, Region X; State of Washington
       Department of Health 6B ML87AOOO.

 Federal Register: August 14, 1998, Volume 63. Number  157, Page 43755-43828.

 Fisher, L.D., van Belle, G. 1993. Biostatistics: A Methodology for Health Sciences. New
       York: John Wiley & Sons.

 Oilman SC, Justice J, Saepharn K and Charles G. (1992) "Cross-cultural Medicine A
       Decade Later" Western Journal of Medicine. Sep;  157-310-315.

Jacobs, et. al, "Estimates  of per capita Fish Consumption in the U.S. Based on the
       Continuing Survey of food Intake by Individuals (CSFII), Risk Analysis, vol. 18.
       no. 3, 1998,283-291.)
API Seafood Consumption Study         62                      EPA 910/R-99-003
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  Javitz H. 1980. Seafood consumption data analysis. U.S. EPA Contract 68-01-3887.
         Prepared by SRI International for the Office of Water/Regulations and Standards,
         Washington, D.C.)


  Kendall, M.G., Stuart, A. 1963. The Advanced Theory of Statistics, vol. 1. New York:
         Hafner Publishing Co., 236-237.

  Landolt, M.L., Hafer, F.R., Nevissi A., van Belle G., van Ness K., and Rockwell, C.
         1985.  Final Report, "Potential Toxicant Exposure among Consumers of
         Recreationally Caught Fish from Urban Embayments of Puget Sound." NOAA
         Technical Memorandum No. OMA 33. National Oceanic and Atmospheric
         Administration. Rockville, MD.

  Landolt, M.L., Hafer, F.R., Nevissi A., van Belle G., van Ness K., and Rockwell, C.
         1987. Final Report, "Potential Toxicant Exposure among Consumers of
        Recreationally Caught Fish from Urban Embayments of Puget Sound." NOAA
        Technical Memorandum No. OMA 33. National Oceanic and Atmospheric
        Administration. Rockville, MD.

  Leikin JB and  Paloucek FP. (1996-1997) Poisoning & Toxicology Handbook. 2nd Edition,
        Lexi-Comp, Hudson, Ohio.


  Matter, AL. (1994). Paralytic Shellfish Poisoning:  Toxin Accumulation in the Marine
       Food Web, With Emphasis on Predatory Snails: U.S.  EPA, Region X; U.S. EPA
       910/R94-005.

 McCallum, M.  1985. "Seafood Catch and Consumption in Urban Bays of Puget Sound."
       Washington State Division of Health, Epidemiology Section.

 Nakano C & Lorenzana R (1996) Asian and Pacific Islander Seafood Consumption Study:
       Exposure Information Obtained through a Community-Center Approach., U.S.
       EPA 910/R-96-007, August 1996).


 OSWER directive 9285.6-03.


 Pierce, D., Noviello D., and Rogers, S. (Dec.  1981) "Commencement Bay Seafood
       Consumption Study." Tacoma-Pierce County Health Department. Seattle, WA.


 Puffer HW, Azen SP, Duda MJ  Young DR (1982) Consumption Rates of Potentially
       Hazardous Marine Fish Caught in the Metropolitan Los Angeles Area. University
       of Southern California School of Medicine.  Departments of Pathology and
       Preventive Medicine. Los Angeles, CA: Report No. U.S. EPA-600/3-82-070. June
       1982.
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  State of Washington Population Trends, October, 1998. Office of Financial Management,
        State of Washington.

  Tebaldi J, Memo to Juliet Van Eenwyk, Acting State Epidemiologist regarding API
        Seafood Consumption Survey Study Review, May 19, 1999.

  Toy K, Gawne-Mittelstaedt G, Polissar N and Liao S. 1996. A Fish consumption survey
        of the Tulalip and Squaxin Island tribes of the Puget Sound region. Tulalip Tribes,
        National Resources Department, Marysville, Washington

  United States Census Bureau, "King County, Washington" (1990).

  United States Department of Agriculture, Continuing Survey of Food Intakes by
        Individuals, Data Set and Documentation (Agriculture Research Service, Beltsville
        Human Nutrition Research Center, Beltsville, Maryland 20705, 1990).

 U.S. EPA, Supplemental Guidance for Superfund Risk Assessment in Region 10, 1991.

 U.S. EPA, Exposure Factors Handbook, U.S. EPA/600/P-95/002Fb, August 1997.

 Washington Department of Ecology, Analysis and selection offish consumption rates for
       Washington State risk assessments and risk-based standards, external review draft,
       March 1999.

 Wong K, Fishing for Food in San  Francisco Bay: Part II. Save San Francisco Bay
       Association, 1997).
API Seafood Consumption Study                                 EPA 910/R-99-003
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                                         64

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Appendix A
     65

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                                                                                       APPENDIX A
                                                                        Questionnaire Number I    I   I    I
ON
                              ASIAN PACIFIC AMERICAN SEAFOOD CONSUMPTION STUDY
DATE CALLED
1) 1 1 1 1
mo day yr
INTERVIEW APPT. TIME
1 ) : PI i am 1 1 2 pm
RESULT CODES
1 ) completed interview 1 li
2) 1 1 1 1
mo day yr
2) : l~| iam [~| 2pm
2) missed appointment;
reschedule db
3) 1 1 1 1
mo day yr
3) : fljam l~l 2pm
3) other Da
        INTERVIEW LOCATION  Q Respondent's house
                            EL Other
Q? RFSC        Da Eatery
        RESPONDENT'S INITIAL
     INTERVIEWER'S CODE I   I    I   I

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                                                                                            APPENDIX A
a.
       \N1RODUCI\ON
       Hello. My name is_
                              and I am (ethnicity). We are conducting a study to understand the seafood
eating patterns of (ethnicity) in the King County area.  The information given in response to this questionnaire will
help the Asian Pacific American community to understand the rates of seafood consumption, ways in which
meals are cooked and prepared, and the types of seafood regularly consumed. A!l information provided in this
interview is voluntary and confidential.  Your answers will be combined with those of others so that no person's
answers can be identified.

DATE OF INTERVIEW I    I   I    I    TIME INTERVIEW BEGINS	:	Qam CJ2 pm

I am going to ask you some questions which will determine whether you are in the group we wish to study.

a) Do you live in King County?            Yes Q          No Ck           (IF NO, TERMINATE INTERVIEW)

b) Do you eat seafood at all?            Yes Q          NoD*           (IF NO. TERMINATE INTERVIEW)

c) Which of the following ethnic groups best describe you.  Check one only.

Filipino Qi       Japanese D?          Korean Q            Chinese D<

Lao di         Mien D?              Hmong Da            Samoan D?
                                                                                  Vietnamese DS

                                                                                  Cambodian dl
d) Were you born in the United States?
                                                  Yes
NoD
(If no, how many years have you been in the United States?)  0-5 D i     6-10

e) Is at least one of your parents born in the United States?

f)  Were both of your parents born in the United States?
(TERMINATE INTERVIEW IF BOTH "D", "F" ARE YES)
                                                                                   11-20 Da   21+D4
Yes

YesD.
                                                                                  NoD?

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                                                                                              APPENDIX A
ON
oo
       g) Are you at least eighteen years old?         Yes Di          No D? (IF NO, TERMINATE INTERVIEW)

       I. I am going to ask you what types of seafood you eat, the amount you eat, and how often you eat each one.

       The amount of seafood you eat and how often you eat it may depend on the time of year.  For example, if there
       are seasonal differences in how often you eat seafood. Please answer 2 different ways: when it is fresh and
       readily available and when it has been frozen, dried, canned, stored, etc. Please answer these  questions in a
       way that's most familiar to you.  Remember to include breakfast, lunch, dinner, and snacks. Do not include
       seafood you eat at special celebrations (holiday celebrations, Chinese New Year, Japanese New Year,
       weddings, community or cultural events, etc.) They will  be asked later.

       —FILL OUT CONSUMPTION FORM—SHOW PORTION MODEL, PICTURE CARD-

       GROUP A
       A1.  How often do you eat the following...
NUMBER OF...PER YEAR
PORTION SIZE CODE
NUMBER OF PORTIONS EATEN
TYPE OF FISH
                                                                                  Model-#'-f;S
       rest of the year

       SALMON EGGS
       rest of the year


       in season
       rest of the year
        rest of the year

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                                                                                       APPENDIX A
       A2.  For the following categories, please tell me approximately what percentage of the fish in Group A you get
       from: —READ ALL CATEGORIES— Answers must total 100%.

       1) Grocery stores/street vendors                                                        	%
       2) Fish caught from Puget Sound by yourself, family members or friends                       	%
       3) Fish caught from outside of Puget Sound by yourself, family members or friends              	%
       4) Restaurants                                                                       	%
       —SHOW PORTION MODEL. PICTURE CARD—
       GROUP B
       B1. How often do you eat the following...
ON
       TYPE OF FISH
       in season
       rest of the year
       DOGFISH
       in season
       rest of the year
       SNAPPER
       in season
       rest of the year
       in season
       rest of the year
       in season
NUMBER OF PORTIONS EATEN PER
NUMBER OF...PER YEAR

PORTION SIZE CODE
                                                             m&%&w-;
       rest of the year

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                                                                                     APPENDIX A
{continualion 61)
TYPE OF FISH
NUMBER OF PORTIONS EATEN PER
NUMBER OF...PER YEAR
PORTION SIZE CODE
                                                                                        Weiaht Un t
rest or the year
ROCKFISH
in season
rest of the year
in season
rest of the year
B2. For the following categories, please tell me approximately what percentage of the fish in Group B you get
from: —READ ALL CATEGORIES—Answers must total 100%.

1)  Grocery stores/street vendors                                                          	%
2)  Fish caught from Puget Sound by yourself, family members or friends:                        	^
3)  Fish caught from outside of Puget Sound by yourself, family members or friends               	7<.
4)  Restaurants                                                                         	5?

-------
                                                                                  APPENDIX A
—SHOW PORTION MODEL, PICTURE CARD-

GROUP C
C1. How often do you eat the following...
TYPE OF FISH
NUMBER OF PORTIONS EATEN PER
NUMBER OF...PER YEAR
PORTION SIZE CODE
                                                            I MONTHS
            MONTH   YEAR
rest or the year
CRAPPIE
rest of the year
CARP

rest of the year
PERCH
rest of the year
rest of the year
BASS
in season
rest of the year
C2. For the following categories, please tell me approximately what percentage of the fish in Group C do you
get from: —READ ALL CATEGORIES—Answers must total 100%.                                     I j

1)  Grocery stores/street vendors                                              	%
2)  Fish caught from Puget Sound by yourself, family members or friends              	%

-------
                                                                                    APPENDIX A
3)  Fish caught from outside of Puget Sound by yourself, family members or friends
4)  Restaurants

—SHOW PORTION MODEL, PICTURE CARD—

Group D
Dl. How often do you eat the following...	
rest of the year
SOLE/FLOUNDER
                NUMBER OF PORTIONS EATEN PER
NUMBER OF...PER YEAR
PORTION SIZE CODE
                                                    WEEKS
              MONTHS

D2. For the following categories, please tell me approximately what percentage of the fish in Group D you get
from: - - -READ ALL CATEGORIES - - -Answers must total 100%.

1)  Grocery stores/street vendors                                                    	%
2)  Fish caught from Puget Sound by yourself, family members or friends                   	%  j
3)  Fish caught from outside of Puget Sound by yourself, family members or friends          	<%
4)  Restaurants                                                                    	%

-------
                                                                                    APPENDIX A
 D3. I'm going to ask you about what parts of the fish in Group A-D you eat. Please tell me what percentage of
 the time you eat the following categories when you eat fish in Group A-D. —READ ALL CATEGORIES FIRST—Please
 answer 0-100%.  Answers 1 & 2 must total 100%.
 1) Fillet with skin:
 2) Fillet without skin:
 3) Head, bones, eggs, organs:
                          _%(l&2total 100%)
                  	% (0-100%)
D4. I'm going to ask you how the fish you eat in Group A-D is prepared. For the following 2 categories please tell
me what percentage of the time you eat fish in Group A-D prepared this way.  —READ ALL METHODS FOR EACH
CATEGORY FIRST—Answers must total 100%.
1)  Baked, boiled, broiled, roasted, poached, or steamed:
2)  Canned, fried, raw, smoked, or dried:
                                          _%(! & 2 must total 100%)
D5. If you boil, steam, poach any of the fish in Group A-D. what do you do with the water it is prepared in?

1)  Throw it out	%         2) Use it in cooking	%          3) Drink it	%

—SHOW PORTION MODEL. PICTURE .CARD-

GROUP E
E1.  How often do you eat the following...                	
TYPE OF SHELLFISH
NUMBER OF PORTIONS EATEN PER
            NUMBER OF...PER YEAR
                         PORTION SIZE CODE
                   WEEK
         MONTH
YEAR
WEEKS
MONTHS
: Weight Unit
CLAMS
(manila/littleneck)

                                                        wm^-^'s-
in season
rest of the year

-------
(continuation of E
                                                                                      APPENDIX A
TYPE OF FISH
NUMBER OF PORTIONS EATEN PER
NUMBER OF...PER YEAR
PORTION SIZE CODE
                                                                             Model #     Weight Unit
HORSE CLAMS
rest of. the year
                                              S^R: .v'-w'yfSn-
RAZOR CLAMS
rest of the year
BUTTER CLAMS
in season
rest of the year
GEODUCK CLAMS
rest of the year
MACOMA CLAMS
rest of the year
COCKLES
in season
rest of the year
in season
rest of the year
 rest of the year

-------
(continuation of El)
                                                                                 APPENDIX
1YPE OF SHELLFISH
NUMBER OF PORTIONS EATEN PER
            NUMBER OF...PER YEAR
                         PORTION SIZE CODE
                    WEEK
         MONTH
YEAR
WEEKS
MONTH
Model #
Weight Unit
ABALONE
                                                                             ^ttt^-.-.f.
                                                                     'Z--*ftss?>tfx&f<&.\\
in season
rest of the year
SCALLOPS
in season
rest of the year
—SHOW PORTION MODEL, PICTURE CARD—
E2.  How often do you eat the following
                                                                             PORTION SIZE CODE
          NUMBER OF...PER YEAR
NUMBER OF PORTIONS EATEN PER
TYPE OF SHELLFISH
rest of the year
 n season
rest of the year

SEA URCHIN
 n season
rest of the year

-------
                                                                                           APPENDIX A
ON
       (continuation of E2)
       FYPE OF SHELLFISH
NUMBER OF PORTIONS EATEN PER
NUMBER OF...PER YEAR
                                                                                  PORTION SIZE CODE
                                                                                                Weiaht Unit
      SEA CUCUMBER


      in season
      rest of the year
      MOONSNAIL
      in season
      rest of the year
      in season
      rest of the year
      —SHOW PORTION MODEL and PICTURE CARD-
      E4. I'm going to ask you about which parts of the following you eat. Percentages for each species must total
      100%.
SPECIES
CLAM
(manila/littleneck)
HORSE CLAMS
BUTTER CLAMS
RAZOR CLAMS
WHOLE




WHOLE
W/STOMACH
REMOVED




WHOLE
W/SIPHON TIP
REMOVED




WHOLE
W/SIPHON TIP
AND STOMACH
REMOVED




TOTAL 100%
TOTAL 100%
TOTAL lOCj^
TOTAL '100%
TOTAL 100%
                                                       11

-------
(continuation of E4)
                                                                                       APPENDIX A
SPECIES
GEODUCK CLAMS
MACOMA CLAMS
COCKLES
OYSTERS
MUSSELS
ABALONE
SCALLOPS
WHOLE







WHOLE
W/STOMACH
REMOVED







WHOLE
W/SIPHON TIP
REMOVED







WHOLE
W/SIPHON TIP
AND STOMACH
REMOVED







TOTAL 100%
TOTAL 100%
TOTAL 100%
TOTAL 100%
TOTAL 100%
TOTAL 100%
TOTAL 100%
TOTAL 100%
SHRIMP
CRAB
SQUID

SEA URCHIN

SEA CUCUMBER

MOONSNAIL

LOBSTER
WHOLE BODY (body and head)
WHOLE BODY (crab meat and
butter)
WHOLE SQUID
%
WHOLE BODY
To
WHOLE BODY
To
WHOLE BODY
To
WHOLE BODY {body and head)
BODY ONLY
MEAT ONLY
MEAT ONLY
(hirwlv nnd t^ntoolp^l

EGGS ONLY
/o
MUSCLE ONLY

MUSCLE ONLY
/o
BODY ONLY
HEAD ONLY
CRAB BUTTER
ONLY

^iSfeife-:

- . - ..-,(} -4 ;»-,V.> i:-..--. -•
'
:,;!.• - « :.",.. "v.''<»- . • il .
.. .:-.lslifA?-»'>]f' -'i*---^ - • 'i •>
, •: . -
-------
                                                                                         APPENDIX A
      E5. I'm going to ask you how the shellfish you eat in Group E is prepared. For the following 2 categories please
      tell me what percentage of the time you eat shellfish in Group E prepared this way. —READ ALL METHODS FOR
      EACH CATEGORY FIRST —Answers must total 100%.

       I) Baked, boiled, roasted, poached or steamed	%
      2) Canned, fried, raw, smoked, or dried              	%
       E6. If you boil or steam any of the shellfish in Group E. what do you do with the water it is prepared in?

       1) Throw it out	%   2) Use it in cooking	%          3) Drink it	%

       E7. For the following categories, please tell me approximately what percentage of the shellfish in Group E do you
       get from: —READ ALL CATEGORIES— Answers must total 100%.
       1) Grocery stores/street vendors
o^      2) Shellfish caught from Puget Sound by yourself, family members, or friends
       3) Shellfish caught from outside of Puget Sound by yourself, family members, or friends
       4) Restaurants

       —SHOW PORTION MODEL and  PICTURE CARD-
       GROUP F
       Ft. How often do you eat the following:	
                                                                                                07
       TYPE OF SEAFOOD
NUMBER OF PORTIONS EATEN PER
           NUMBER OF.. .PER YEAR
                         PORTION SIZE CODE
                         WEEK
          MONTH
YEAR
WEEKS
       SEAWEED
       in season
MONTHS
       rest of the year
       KELP

       in season
       rest of the year
                                                        13

-------
                                                                                 APPENDIX A
F2. For the following categories, please tell me approximately what percentage of the seafood in Group F you
get from:  —READ ALL CATEGORIES—Answer must total 100%.

1) Grocery stores/street vendors                                                    	%
2) Seafood caught from Puget Sound by yourself, family members, or friends              	%
3) Seafood caught from outside of Puget Sound by yourself, family members, or friends	%
4) Restaurant                                                                             %
Are there other seafoods which you eat that were not mentioned earlier? Qi Yes

G 1 . How often do you eat. . .
                                                                              No (If no, go to H
TYPE OF
SEAFOOD
^^^^^t^_






NUMBER OF PORTIONS EATEN PER
WEEK






MONTH






YEAR






NUMBER OF.. .PER YEAR
•WEEKS






MONTHS






PORTION MODEL CODE
fWBSRHtfit1^^






—SOCIAL EVENTS-

HI.  The following questions will ask about your eating patterns at social events. In the last 12 months, how often
did you attend special celebrations (holiday celebrations, Chinese New Year, Japanese New Year, cultural or
community events, weddings, etc.):	times in last 12 months  (If 0, go to no. I 1)

H2.  At what percentage of these events do you eat seafood? Please answer from 0-100%.	%t
answer Is 0, go to I 1)
                                                 14

-------
                                                                                           APPENDIX A
       —SHOW PORTION MODEL and PICTURE CARD-

       MS. At these events, how much seafood do you usually eat each time?	oz.

       H4. How often do you eat the following seafoods at these events? You may answer from 0-100%.

       SHELLFISH (crab, clam, shrimp...)	%      SEAWEED/KELP	%      FISH

       11. Please indicate your age	. If you choose not to, please select your age category.
       18-29D1        30-54 D2       55+D3

       12. Indicate your weight:	pounds OR	kilogram.

o      13. Indicate your height:  	feet	inches

       14. What is your household income per year?
       D10-10,000      D 210,001-15,000      D 315,001-20,000      D < 20.001-25,000
       D 5 25,001-35,000      D 6 35,001-45,000       0/45,001 +

       15. How many people are supported by this total income?	
        16.  Indicate the level of formal education. (~li completed high school   CL did not complete high school
           completed college       Ch did not complete college       Ds other	
                                                         15

-------
                                                                                     APPENDIX A
 17. We want to thank you for your answers to these questions because they will give us valuable scientific
 information about seafood consumption in the Asian Pacific American communities. We also want to make this
 information available in a useful form to Asian Pacific American community members and families through
 educational materials.

 To understand community needs and concerns we would like to ask your opinion on several topics.

 What are the sources that give you the best/most reliable information about what is going on in the Asian Pacific
 American community?  —CHECK ALL THAT APPLY—

 community newspaper/newsletters	
 community centers	
 bulletin boards	
 radio broadcasts in English	
 radio broadcasts in your own language	
 television	
 temple/mosque/church	
word of mouth_	
of her, please specify.
The following are ways people learn about things. Please select the two that you prefer. If there are others that
you prefer which are not on the list, please tell us what they are.

Read in books or pamphlets	
listen to someone in person	
listen to a tape recording	
learn it on computer	
see it on video	
see it in a slide show	
read in comic book	
other	
                                                 16

-------
                                                                                              APPENDIX A
       What kinds of information would you like to have about fish and other seafood?  If there are other items that are
       not on the list, please tell us what they are. —CHECK ALL THAT APPLY—

       Health information about eating fish	
       information on safe preparation of fish	
       safety of eating fish and other seafood from Puget Sound	
       types and amount of fish eaten by members of the Asian Pacific American community	
       safety of fishing from specific locations in Puget Sound	
       others	

       The following are sources for people who fish to find out about the safety of fishing in a particular site. If you fish,
       which of the following are  most useful to you? —CHECK ALL THAT APPLY. INDICATE "NOT APPLICABLE" FOR THOSE
       WHO DO NOT FISH—

       not applicable	
°°      word of mouth (friends, acquaintances)	
       posted warning signs on docks and other fishing places,
       pamphlets	
       Washington State Dept. Shellfish Information	
       Red tide hot line	
       County Health Department	
       not concerned about the safety of fish	
       never try to find out	
       other, please specify	
                                                         17

-------
                                                                                         APPENDIX A
       CONCLUSION

       Thank you for your cooperation in participating in this study. Your participation will contribute important
       information needed to help protect your natural resources and provide guidance for public health programs for
       your community.


       NOTE TIME INTERVIEW ENDS:                  :      Pi AM  Da PM

       —INTERVIEWER REMARKS—

       Jl. Respondent's cooperation was: Di Very good  [IkGood        Da Fair    D« Poor
       J2. The quality of respondent's answers were: Qi High quality  {_}* Generally reliable
       Os Questionable O< Unreliable
00
       J3. What was the main reason for the questionable or unreliable quality of the
       interview?	;	

       J4. Respondent's Gender        Female Qi           Male D*
       J5. Further
       comments:.

-------
Appendix B
     84

-------
00
                                                                                                                                                            •o
                                                                                                                                                            •o
                                                                                                                                                             re

                                                                                                                                                             D
                                                                                                                                                             0.

-------
Models and Model Weight used in the Computation of the API Survey
^^B^T«T^TH i-T^*i
Group A



Group B







Group C





Group D



Group E1






Group E2





Group F

ateoorv Seafood Species
Salmon
Salmon Eggs
Trout
Smelts
Cod
Dogfish
Snapper
Snowfish
Mackeral
Tuna
Rockfish
Herring
Catfish
Crappie
Carp
Perch
Tilapia
Bass
Halibut
Sole/Flounder
Sturgeon
Suckers
Clams (manila/macoma)
Clams (horse/razor/geo'
Clams (butter)
Cockles
Oysters
Mussels
Abalone/Scallop
Shrimp/Lobster
Crab
Squid
Sea Urchin
Sea Cucumber
Moonsnail
Seaweed (dried)
Seaweed/kelp (fresh)
Model Code
B
E .V.
B
D
C
D
A
A
B
C
A
D
B
A
B
A
A
A
C
C
B
B
J
L
K
M
N
6
1
F
P
R
E
S
T
G
H
Weiqht used
: 14.502*28.35*0.562=231.02 g
0^02*28.35=14/18 g"
14.502*28.35*0.562=231 .02 g
..• .-- --. • _ -•-**,
2.5oz*28.35*.876-62.09 g
255.15 g
2.5oz*28.35*.876=62.09 g
16.5oz*28.35*.49=229.21 g
16.5oz'28.35*.49=229.21 g
14. 5oz*28.35*0. 562=231 .02 g
255.15 g
16.5oz*28.35*.49=229.21 g
2.5oz*28.35*.876=62.09 g
1 4. 502*28^35*0^562=231 .02 g ./
16.502*28.35*.49=229.21 g^ -
1 4.502*28.35*0.562=231 .02 \ g
16.502*28.35*.49=229.21 g
1 6.502*28.35*.49=229.21 g-
1 6.5ozt283&.49=229.21 f £
255.15 g
255.15 g
14. 5oz*28. 35*0.562=231. 02 g
14. 5oz*28.35*0. 562=231 .02 g
28.35Tg "
' 92 g
56.70 g
^55 g\
"237 g
56.70,g'
25.52' g
127.58 g
334.07 g
226.8 g
14.18 g
99.23 g
40 g
8^51 g
56.7V
One Portion = Note 1
1 fish
1 container
1 fish
1 fish
3 fillets
1 fish
1 fish
1 fish
1 fish
3 fillets
1 fish
1 fish
1 fish
1 fish
1 fish
1 fish
1 fish:
1 fish-' :
3 fillets
3 fillets
1 fish
1 fish
6 clams
1 clam
6 clams-
3 'clams -^
3 oysters
4 mussels
1 container
3 shrimps
one crab (analyzed) Butter+Meat only
3 pieces
1 container
1 cucumber
1 shell
1 package
1 container

-------
                                                                  Appendix B-3-a
Calculation of edible meat percentage for Models A, B, D, and P.

To determine accurate weight of serving sizes for Models A, B, D and P (crab), the
models were used to purchase nine or ten additional fishes or five crab of approximately
the same size for each of the four model species and the crab model. Two purchases of
fish or crab each were made two weeks apart to increase the likelihood that the fish or
crab were not from the same catch.  The intention was to characterize potential variability
in size of fish or crab.  The uncooked fishes were cleaned by five volunteers from the API
community using typical methods. Both the volunteers and the CSC said that sometimes,
but not always the head, gut, brain and eyeballs were eaten. Therefore, weights for these
tissues as dissected by the volunteers were also obtained. A variety of volunteers were
used with the intention to characterize potential variation in cleaning methods. The crabs
were cooked and edible portions removed from the shells by two API volunteers. Crab
meat and crab "butter" were separated from individual crab by the volunteers in the
manner in which they would be eaten. Cleaned fish, fish parts, crab meat and crab butter
were weighed by a trained person using an electronic balance. Tables B-3-a-d show the
data from which the percentage of edible meat were determined for each model.

B-3-a. (Model A)
Model A ( lilapia
Fish

#1
#2
#3
#4
#5
#6
#7
#8
#9
#10
Mean
sb H
95% Cl

Whole
(entire)
447.48
584.20
459.14
431.16
516.92
674.20
694.30
659.90
437.33
657.90
555.95
109.38
67.79

Body Meat
(without gut, (skin-t-desh)
fins, tail, head)
329.51 251.39
420.14 274.66
315.94 239.89
308.57 236.98
368.92 208.99
498.01 323.85
497.84 317.29
433.21 322.81
271.34 203.19
414.48 267.38
385.80 266.58
79.44 45.62
49.23 28.28
••••
Head
without gills)
59.93
83.52
83.80
56.40
94.20
77.59
58.87
94.57
92.39
133.78
83.47
- 23.08
14.31
••••
Gut

15.43
45.42
42.72
22.81
39.65
48.36
72.75
72.25
32.95
36.99
I 42.93
| 18.53
11.49
^^••1
Eyes& Brain

5.96
4.28
6.64
5.71
6.45
6.58
5.40
5.84
5.34
7.54
: 5.97
0.89
i 0.55
                                      87

-------
B-3-b. (Model B)




Model B (Trout)
                                                            Appendix B-3-b/B-3-c
Fish Whole Body Meat Head ; Gut Eyes & Brain

#1
#2
#3
#4
#5
#6
#7
#8
#9
Mean
SD
95% Cl
(entire)
572.26
515.32

595.20
553.65
694.60
510.64
537.45
598.13
572.16
59.47
43.21
(without gut, ^skin+flesh)
fins, tail, head)
328.03
276.03
311.90
378.79 297.95
412.07 337.61
467.76 357.13
332.62 280.17
345.65, 297.94
404.37i 343.71
388.54 1 314.50
42.14 27.08
33.72 17.69
(without gills)
83.70
105.22
105.21
98.34
118.20
69.09
67.19
71.48
76.47
88.66
17.66
11.54

65.89
49.70
54.33
44.44
63.87
110.01
63.71
69.63
77.73
66.59
18.14
11.85

6.60
4.38
6.11
6.55
8.91
9.12
6.79
7.69
6.79
6.99
1.36
0.89
B-3-c. (Model D)




Model D (Herring)

#1
#2
#3
#4
#5
#6
#7
#8
#9
#10
Mean
SD
95% Cl
(entire)
231.15
246.55
227.60
149.67
229.12
252.33
211.18
230.32
243.52
256.46
227.79
29.20
17.99
(with head; i
without gut & '
Kills
205.02
219.10
201.69
129.37
203.80
214.51
183.97
200.88
213.04
225.73
199.71
25.88
16.04

-------
                                                             Appendix B-3-d
B-3-d. (Model P)
Model P (Crab) Whole Body Cooked Weights 1


crab
#1
#2
#3
#4
#5
Average
SD
95% Cl
Upper 95% Cl
Lower 95% Cl
Pre-cooked
(grains)

758.30
643.50
626.20
823.90
699.60
710.30
81.94
71.82
782.12
638.48
Cooked
(grams)

649.00
586.82
594.84
738.80
605.70
635.03
62.78
55.02
690.06
580.01
Butter
;§rams)

118.42
111.56
97.56
122.52
124.64
114.96
10.88
9.54
124.50
105.42
Meat
(grams)

254.54
208.27
193.91
227.28
211.54
219.11
23.09
20.24
239.34
198.87
                                   89

-------
Appendix C
     90

-------
                          SPECIES MANUAL
                           GROUPA
APPENDIX C
 SALMON
 SALMON EGGS
TROUT
SMELT

-------
                        SPECIES MANUAL
                         GROUP B
APPENDIX C
 COD
 DOGFISH
SNAPPER

MACKERAL
                              92

-------
                        SPECIES MANUAL
                         GROUP C
APPENDIX C
CATFISH
CRAPPIE
CARP
                             93

-------
                        SPECIES MANUAL
                         GROUP D
APPENDIX C
 HALIBUT
 SOLE
STURGEON
SUCKERS
                             94

-------
                      SPtCliib MANUAL



                      GROUP E
MANILA LITTLENECK CLAM
RAZOR CLAM
                                    HORSE CLAM
        MACOMA CLAM
                                    BUTTER CLAM
GEODUCK CLAM
                             95

-------
       Group F
APPENDIX C
SEAWEED N/4
KELP N/A
                             96
                                       NEKEOCYSTIS

-------
Appendix D
      97

-------
                                                            APPENDIX D
                         Interviewer's Telephone Script
 Hello, my name is	
 afternoon OR evening?
                                           How are you this morning OR
I'm with the
                              community, and I am working with the Asian Pacific
 American Dietary Habit Study. Do you remember sending a post card saying you are
 interested in learning more about the study?

 As you know, this study will help make health recommendations that are specifically for
 Asian Pacific American communities, especially for families and children. A!!
 information provided in this interview is voluntary and confidential. Your answers will be
 combined with those of others so that no person's answers can be identified.

 One of the challenges we have in this study is that we cannot interview everyone in the
 community, so we have to rely on a smaller group to represent the larger group. To
 ensure that we represent the larger group we need to ask you the following five short
 questions.
 1.  Do you live in King County?
2.  Do you eat seafood?
3.  What is your age?
4.  What generation are you?
                               If yes: go to #2.
                               If no: I'm sorry, our study is targeting residents
                               living within King County only. Thank you for your
                               interest.

                               If yes: go to #3.
                               If no: I'm sorry, a very important part of our survey
                               addresses seafood consumption and we are
                               targeting people who consume at least a little
                               seafood. Thank you for your interest.

                               If yes: go to #4.
                               If no: a. I'm sorry, this study is only interviewing
                               those older than 18 years and older
                               b. I'm sorry, we have enough respondents for that
                               age group.

                               If yes: go to #5.
                               If no: I'm sorry- this study is targeting only 1" and
                               2nd generation Asian Pacific American groups.
                               Thank you for your interest.
5.  Could you verify your ethnicity? If yes: see page 2
                                If no: I'm sorry, this study is targeting the following
                                groups:  Cambodian. Chinese. Korean. Filipino.
                                Japanese, Samoan. Vietnamese, or Lao (Mien,
                                Hmong).
                                     98

-------
                                                               APPENDIX D
If accepted:

Thank you for your patience and cooperation. You are eligible to participate trrthe
Asian Pacific American Dietary Study. The next step is a 45 minute face to face
interview with me at a location convenient to both of us (your home, your office, e~tc.)
where I will read you a number of questions and record your answers. You will be
reimbursed with $25.00 check or grocery certificate equivalent to $25.00 for a full
interview.  Again, all information provided in this interview will be kept confidential and
voluntary.  Your answers will be combined with those of others so that no person's
answers can be identified.

When would you like to arrange an interview appointment?  And where would you like
to be interviewed?
                                          99

-------
Appendix E
     100

-------
                                                APPENDIX E
nucono or CONTACTS
SUUJEC7 10 I:
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DAY or
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Ct/ifi)/ CCK/O;









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	 .. . 	 _...... _. . — _ — ,-T,._-_ ^ .-_.
COMMENTS















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ID NUM5UII 1
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-• — — • • • —••"•> — —•

RESULT COOES
01 -lMiurvi<™comnioiu O-l-U.iav.UU.lilu 0» - llos|iofulom Movu.l IU - Ca« l»cli. no apfiolninuml nindo
0? • Holujal 05 - Larvouso" I'lohlorn W - OHw 1 > - No answoi. r»o polnlmont M;ulo Vf - l.kra D«sy (mlaplrana)
•FINAL OUTCOME CODE (EntoiodbySupoivitQi): l_|_l
OutcomoCwlov 01 - C«nplolo 03 - Oocrtasecl 05 - LiuWwflo OS -Too II OT - l'«i,ich«l
U C ^ '• o-» - l\olu!i.l O-l - Uiinvaaahl- riolihin, O/ - MOVMCI h«n A,.,;, yri - Oil.o,
_Tr---..-r--v~ — ------- ^ 	 =— 	 ; 	 •" ' " '

-------
Appendix F
     102

-------
                UNIVERSITY OF WASHINGTON      APPENDIX F
 Name of Religious Organization
 Address
 City, State Zip Code

 Dear
 Several weeks ago, we contacted your organization to help us identify individuals within your
 community. We would like to take this opportunity to re-contact you to explain how the Asian
 Pacific American Dietary Habit Study may meet your organization and community's needs. We
 feel that we may have misrepresented the study's mission and goals.

 The Asian Pacific American Dietary Habit Study is a community owned study. Currently, there is
 no existing study of this nature:  this is the first. The Asian Pacific American community has been
 a strong stakeholder and voice in the planning, development, and design phases of the study. We
 wish to continue this approach.  By assisting us in the study, you will be a strong voice for the
 your community in providing positive change in the government regulations as well as developing
 culturally appropriate educational curriculum.

 Since our last discussion, we have gained tremendous cooperation from the religious
 organizations within your community.  Roughly 30 Asian Pacific American organizations have
 either shared their membership directory with us or distributed letters on our behalf using the
 directory.  We are approaching your organization again to reconsider sharing your directory or
 distributing the letters among your members. We do not want your community to be
 underrepresented so we urge you to participate and be included in the study.

 We are willing to make visitations and/or attend board meetings to discuss how we may be able to
 work together.

 Regardless of your decline, we plan to share the data results with you for the benefit of your
 family, children, and community's health.

 We would truly appreciate it if your organization would reconsider your decision.

 Sincerely,
Connie Nakano                          Ruth Sechena, MPH, MD
Study Coordinator                        Director, Environmental Risk Information Service
Refugee Federation Service Center         University of Washington
                                             103

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   GARY LOCKE                             ^^S^                       APPENDIX F
     Governor                               ^^"""'^
                                    STATE OF WASHINGTON

                             OFFICE OF THE GOVERNOR                  —
       P.O. Sox 40002 •  Olympia, Washington 98504-0002 • (360) 753-6780 • TTY/TDD (360) 753-6466
 June 13,1997
 Dear Asian Pacific Americans of King County,

 I am writing to encourage your participation in the Asian Pacific American Dietary Study, a
 study being conducted by the University of Washington and the Refugee Federation Service
 Center, and funded by the U.S. Environment Protection Agency.

 Health guidelines in this country are based on dietary studies.  Most of the dietary studies,
 however, are based on the general population and may not reflect certain regional and cultural
 factors.  This study will provide scientific  documentation through person-to-person interviews of
 the eating preferences of 10 Asian and Pacific American ethnic groups (Cambodian, Chinese,
 Filipino, Hmong, Japanese, Korean, Lao, Mien, Samoan, Vietnamese) in King County.

 The information gathered in this study will help individuals in these ethnic groups better evaluate
 their health risks. It will also be used to develop culturally appropriate educational materials
 regarding dietary practices, and to establish a model for future studies throughout the United
 States.

 Your participation in this study will help assure that you, your family and your community are
 properly represented in this pioneer study.

 Sincerely,
GaryZ-ocke
Governor
                                            104

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     Refugee  Federation Service Center
    7101 Martin Luther King Jr. Way 5., Seattle, WA 98118 / 206-725-9181  Fax 206-725-9175
     1215 S. Central Ave.. Suite 210. Kent. WA 98032 / 206-852-5150  Fax 206-852-1136
   	1002516th Ave. SW. Seattle, WA 98146 / 206-762-4894  Fax 206-762-4034—
                                                                APPENDIX F
                           Agreement of Consent

 We, the Refugee Federation Service Center, affirm that we will use the agency's
 mailing and roster lists solely for the research purposes of the Asian Pacific American
 Dietary Habit Study.  These purposes include identifying and selecting individuals to
 invite to participate in this voluntary study. We will protect the names and addresses
 on the lists from unauthorized usage.  We will destroy the lists after the study is
 conducted.
Connie Nakano, Study Coordinator     Simon Truong, Social Service Director
Date                               Date
                                     105

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Appendix G
     106

-------
                                                                   APPENDIX G

                UNIVERSITY  OF  WASHINGTON
 We need your help!  The University of Washington is studying the Asian Pacific American Dietary
 Habit Study.  You have been chosen to take part in the study. 200 Asian Pacific American
 community members will be interviewed to obtain valuable information about what you eat.

 Please sign up for an interview by calling one of the following interviewers (see below) any time
 of the day or night. Interviews will be held at your most convenient time and location.

 •  Cambodian	      @     	
 •  Chinese                                   (3).
    Hmong             '	      @
    Filipino          	      @
    Korean	      @
    Japanese         	      @
    Lao             	      @
    Mien            	      @
    Samoan	      @
    Vietnamese                                 (cb.
Your answers and identity will be kept confidential.  In addition, you will receive $25 after the
questionnaire is completed.  An interviewer will be contacting you within 5-7 days to confirm
your participation in the study.

Your answers are extremely important to your family's health arid your community! Your help is
greatly appreciated.

Sincerely,
Connie Nakano                          Ruth Sechena
Study Coordinator                       Director, Environmental Risk Information Service
Refugee Federation Service Center         University of Washington
                                           107

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       ^T^rBST-t. « S ± » ^ « « ^ II X *i
       
-------
                         HMONG
                                                                                                                 APPENDIX G
Pub ib zejlsoom numb zog Iliiab ua lau $25 los yam yooj yini.

i'suas yog iminb Itb ran tliinb xn rov qnb xwb! Lossis intiiih ib (him
itawv uas mu|aj koj njie, clmw nyob lo nrng. Nqi xa twb them uantej
a win, koin yoojyim rnti koj.
Zliaw Nyob
Nroog, Xeev, Zip code

 Xoviooj

 llaiv Necg
 I Inub nyoog
'Hiov khij voojvoog:   Txivncej   Pojiiiam
                                                                           SAMOAN
                                                   PESCMSCMNI i ou TAGATA ma M/\U/\ oi ma le FILEMU se
                                                   Na ona faalumu lava ma toe mcli vave mail  Po'o le faapipi'i iai ma lot.
                                                   pepa faailoga i lau galuega. Ua mae'a ona lotogi atu le toe meli mat.

                                                   Svinfn
                                                                        Tualusi
                                                   Nuu, Selctc. Numcra Ogamui_

                                                   Nuinci a Tclclbni
                                                                         Tnnc
                                                                                     Fa fine
                           MIEN
                                                                                                VIETNAMESE
             TICNGX uicih nyei l.AANC7^ 7AANCC micnh
             canx IIUNC-IIKC niETV S25.00 nyanuli
             Fluh zlnngx nilngli, aTnt zorqv mclli nycllmUiirss curd nactv
             jlcnv lluzjulx Jaux itnnani; iiztion oc!

             Julx llcnx ihiux nqaan gtiycl (s1:iiiip)J:i:i-T.liili nsirlv zl:iii|>x nilileiie
              bxin incih mini..
             Name ___ ______________
             Address ____ _ ____________
             Cily, Slum. 'li\> Code _________________ ; ___
              I'houc No. _____________
              I Iai fingx mienh	
              llnynngh Jcv	Tovfcifingjienw  Nnin   Nyion/
G-ivip t\d Cong  Doncj b<
XJm  «(!en veto nMng clii \\et
 keih tbeo tl«nb tliiep cito
Ten:
                                                                                         c\\jdc  \vc\  \\\\*  \c\o
                                                                                                » c/di \\-c\  loi!
                                                                                                cnn  \rc\ bM'u phi
                                                       w cli:
Tlicwh Plio, tlen bone;, aip  cot(&:

So *(ien
      •
Dcin  toe

TMOI'
                     XJin vonci tron:
                                                                                                   XIni

-------
               LAO
            zmu u.3i
ii'xiTiivpJ it. U rj. Inn;: 1(4J. n^ufpo. tmi, OIUMU


   .'-ioVuiUiu* & tiv>iktiniv.:i»o»>i)-j

        .«• % .....       ....
   ti;vi let cmi D*J f>ai'ujuuuivij«i>.i.
v. iu
              CHINESE
                                                                                              APPENDIX G
                                                                                  KHMER
                                                                          \iuihmi

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                                                               .»
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                                                                   ut
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                                                            u\nfiHfiOiJTfifoifiOiJfii5fhiiinaj m-^  wtyiuf
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                                                                                    KOREAN
                                                                      ~) o|
                                                                                                                A

-------
Appendix H
     in

-------
                                                APPENDIX H
               WE NEED YOUR HELP!
     PARTICIPATE IN A University of Washington
               DIETARY HABIT STUDY!

  Each chosen volunteer will be paid for a full interview with a
            $25 check or a grocery gift certificate.

 VOLUNTEERS MUST  BE:

     •  Korean, Chinese, Japanese, Filipino, Samoan,
        Vietnamese, Lao (Mien and Hmong), or Cambodian
        ethnicity
     •  1st generation* Asian Pacific American or
     •  2nd generation** Asian Pacific American
     •  18 years or older
     •  Living in King County

 To participate, please call one of the bilingual interviewers:

     Cambodian	
     Chinese	
     Filipino	
     Japanese	
     Korean	
     Lao	
     Hmong	
     Mien	
     Samoan	
     Vietnamese	
The information you provide is extremely important to your
community!

Volunteer for an interview now!  Bilingual services are available!
•I" generation: those who were born abroad and immigrated to US from their country
"2nd generation: children of 1" generation immigrants and born in US
                          112

-------

       i/

 j/'^t"
                    APPENDIX H

If" fU™r™^*~

0-
     /  '    >-
    0  "
                 ;
                                            \
                 '
              v/v'6/

   ^ ^> (/ £  —    9  /
          \>
           «v    \
        p T"A f il ^»« ^-». 1 •>.

-------
                                                         APPENDIX H
                           ffo!
                        $25.00 m
       c^ eulecfy 6ld& :
   A _  K
•
         aD cn^S, ^u, S^u, SSOu, sojeu, OJODOD, 390(2031), £5), ccas

2CDD
                  : ibucieoc#D Sucec^
            0 8%en6f>

             d King County
                              .725-9181
                              114

-------
          UA MATOU MANAOMIA LAU FESOASOANI!      APPENDIX H
       0 SE SU'ESU'EGA TAU MEA TAUMAFA MASANI!
       Oseolea filifilia ina ia tuufesiliina ole a ia maua se siaki e
          $25.00 lona aofa'ipo'o se faatauga mea taumafa foi.

 0 e manaomia ona tuuofo mai:

 •    Kolea, Saina, Sapani, Filipino,. Samoa, Vietinamu, Lao (Mien ma
     Hmong), ma Kemupotia.
 •    Auga tupulaga muamua (1)* Amerika Asia Pasefika po'o
 •    Auga tupulaga lona lua (2)** Amerika Asia Pasefika
 •    18 tausaga po'o le matua atu
 •    0 lo'o alaala nei i  King County

     Faamolemole faafeso'ota'i	.  po'o
         0 faamatalaga o le a e aumaia e matua taua tele mo
                        le faapotopotoga!

    Ofo mai loa ina ia tuufesiligia oe! E maua fesoasoani i lau lava
                            gagana!

•Auga tupulaga muamua (1): O e sa fananau i fafo atu o Amerika a ua malaga mai ma nonofo i Amerika
-Auga tupulaga lona iua (2): O fanau a le auga tupulaga muamua (1) ua fananau i Amerika
                               115

-------
             UNIVERSITY OF WASHINGTON        APPENDIX H
•   -f
                         116

-------
                                               APPENDIX H
        CHUNG TOI CAN QUI BA N GIUP D6
 THAM GIA VAO CUQC PHONG VAN NGHIEN CUfU
                TA P TUC AN UONG.
 Moi ban $\16c chpn tham gia cuoc phong van, sau khi hoan tat ban se Ajc
      tra thu \ao $25 ^ong bln^ chi phi£u hole phieu thi/c phlm.
Nhilng n^Lfoi ti/ nguyen tham gia phai la :

• Ngifcfi £)ai Han. Trung Hoa, Nhlt, Phi Lu|t TBn, Samoan. Viet Nam, Lao
  (Mien & Hmong). hoac Cam D5t.
• The"'he thiJ nhlt: 0) ngi/dl My g6fc A Ghlu (ngJicfl A Ch^u sinh <5" cac niT^c
  ngoai dSn sdhg cf My)
• The^he thtJ hai: @ NgiJcfi A Chiu sinh 3e <3 MY ( con chau cua nhLfng ngi/ol
  the'he thiJ nhlt sinh ^e £ My)
• £)u 13 tu3i ho|c hcfn
• Hien cif tru trong quan King
• Xin vui long gpi cho JEFF DANG   tai $6	hoac
  314-3556 or 277-2599
• Tin trfc ban cung cl'p cho chung toi vo cung c^uan trpng dof vot Cong £>ong
  ban.
M6l BAN THAM GIA CUQC PHONG VAN NAY!
CHUNG TOI SE CO NG J6l  THONG D|CH CHO
QUYVI.
                           117

-------
                                                                APPENDIX H
               YIE MBUO QIEMX ZUQC OIX LONGC MEIH TENGX!

       BIEQC DAAIH CAUX JIENV NAAIV NORM KAUV ZAAH NYANC HOST

                               NYEI JAUV OC!


    Halx dauh zuqc ginv daaih zoux sievjev nyeimienh naalv se duqv $25.00 nyaanh

                 check Fai duqv maaiz lai nyei zing-nyeic nyaanh.


  Bieqc daaih zoux siev jev nyei mienh. se oix zuqc zeiz:
 . Jan-Korea. Jan-Kaev, Jan-l Benv, Jan-fllipin, Jan-Samoan, Jan-Jau-Zei, Jan-La-zaa
 (Mien caux    Baeqc-Miuh) caux Jan-K'Menx.
 . Da'yietv seix* mbuo Asia caux Jan-Pacific America a'fai


 , Da'nyeic seix** mbuo Asia caux Jan-Pacific America


  18 hnyangx gu'guaaic mdengx nyei mienh


  Yiem naaiv King County deic nyei mienh


      Tov meih heuc daaih lorz	:	Dienx waac hoc	a'fai
Meih gorngv daaih nyei waac naaiv se gengh jienv haic nyei bun meih nyei laagz
zaangc mienh camv!

Tov meih sie jev bieqc daaih bun yie mbuo zaah naaic meih oc!  Yie mbuo yaac
aengx maaih mienh tengx faan waac nyei!
        seix: Cuotv seix yiem meih nyei deic bung, iiuz biaaux daaih yiem naaiv
Meiv Guoqv nyei mienh.

"Da'nyeic seix: Da'yietv seix biaaux daaih yiem naaiv Meiv Guoqv aengx caux cuotv
seix yiem naaiv Meiv Guoqv nyei fu'jueiv.
                                    118

-------
                         UNIVERSITY OF WASHINGTON         APPENDIX H
                             PEB XAV TAU KOJ KEY PAB!          __
    KOOMTES RAU KEY KAWM TXOG TEJ KHOOM UAS IB TXWM NOJ!
  Txhua tus uas raug xaiv thiab txaus siab los teb tej lus nug kom tiav yuav tau txais ib daim tshev
                          $25 lossis ib daim tshev muas noj $25.
 Cov txaus siab yuavtsum yog neeg:

 • Kauslim, Suav, Yijpooj, Fislispisnaus, Xaismoos, Nyablaj, Nplog (Co thiab Hmoob),

    lossis Khasnpausdias

 • Txheej 1 * Neeg Tawvdaj nyob tebchaws Asmesliskas tuaj Esxias tuaj lossis

 • Txheej 2** Neeg Tawvdaj nyob tebchaws Asmesliskas

 • Dhau 18 xyoo rov saud

 • Nyob koom tib lub nroog (King County)


                 Thov tivtoj rau   •	lossis


Tej uas koj qhia txog mas tseem ceeb kawg nkaus li rau ib zejtsoom nruab zog!

Tus uas txaus siab, cia li tso npe rau ib qho maimnav! Neeg txhais koj yam lus, peb muaj!

Txheej 1: Cov uas yug nyob yus tebchaws thiab tau tsiv teb tsaws chaw tuaj rau US (tebchaws Amesliskas)
Txheej 2: Cov menyuam ntawm txheej 1 uas tau yug nyob rau US (tebchaws Amesliskas)
                                             119

-------
                                            Appendix H
        UNIVERSITY OF WASHINGTON
                      o] 7114,
o]uf
                     120

-------
                                              APPENDIX H
    KAILANGAN NAMIN ANG INYONGTULONG
   SUMALI SA University of Washington DIETARY
                   HABIT STUDY!

     Ang mapiling boluntaryo ay mabayaran ng
   dalawamput limang dolyar tseke o grocery gift
                     certificate.
 Mga boluntaryo ay:

     •  Korean, Intsik, Hapon, Filipino, Samoan, Vietnamese,
       Lao (Mien and Hmong), o Cambodian ;
     •  Unang generasyon* Asian Pacific American o;
     •  Ikalawang generrasyon** Asian Pacific American;
     •  Labing walong taon o ma$ matanda;
     •  Nakatira sa King County.
Tawagan long ninyo ang numerong ito:

    Filipino..!	,		o;
Ang mga impormasyon na ibigay ninyo ay malaking
bagay para sa inyong komunidad!

Magboluntaryo na kayo para sa pagtatanong!  May tutulong
sa inyo sa pagsasagot.
•1" generation: those who were born abroad and immigrated to US from their country
"2nd generation: children of I" generation immigrants and born in US
                         121

-------
                                                                                          APPENDIX H
                                             f a-
                                                                       %  25
o 7





o 7
                                     "J JJ > 2 it "g & -5 C. «»: .
                                       at   «t
                                              ^ a--r^  -Ci
«  i it
                                                   122

-------
Appendix I
     123

-------
                UNIVERSITY OF WASHINGTON
                                                        APPENDIX I
                  CONSENT FOR FUTURE CONTACT
 Resooncfent Code:
 I agree to be recontacted so that I can consider whether or not to
 participate in a future study.
 Signature                        Date
Please list below two contacts (relatfves^or friends) who will be able to
help us find you if you move. We will only contact them in the event that
we are unable to reach you after several attempts.

1.  Name of friend/relative:	_	.
   Address:	
   Telephone:.
2.  Name of friend/relative:
   Address:	
   Telephone:.
                             124

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Appendix J
     125

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                                                                                                   Appendix J
                                                                             Questionnaire Number II   II
                             ASIAN PACIFIC AMERICAN SEAFOOD CONSUMPTION STUDY
                                              Re-inlerview data
DATE CALLED
1) 1 1 1 1
mo day yr
RE-INTERVIEW TIME
1) : D tarn CD 2 pm
RESULT CODES
1| completed interview d
2) 1 1 1 1
mo day yr
2) : D iam D 2pm
2) other Qz
3) 1 1 1 1
mo day yr
3) : DiamQjpm

INTERVIEWER'S CODE I

-------
                                                                                                                  Appendix/
     A1. How often do you eal the following...
K>
                       NUMBER OF PORTIONS EATEN PER
                                                                NUMBER OF...PER YEAR
A2. For the following categories, please tell me approximately what percentage of the fish you get from:	READ ALL
CATEGORIES---Answers must totall 00%.

1) Grocery stores/street vendors                                   	%
2) Fish caught from Puget Sound by yourself, family members or friends	%
3) Fish caught from outside of Puget Sound by yourself, family members
    or friends                                                    	%
4)  Restaurants                                                  	%

A3. For the following categories, please tell me approximately what percentage of the shell fish you gel from:	READ ALL
CATEGORIES - - -Answers must total 100%.
 1)  Grocery stores/street vendors                                   	%
2)  Fish caught from Puget Sound by yourself, family members or friends	%
3)  Fish caught from outside of Puget Sound by yourself, family members
    or friends                                                    _,	%
4)  Restaurants                                                  	%

-------
                                                                                                              APpendixJ
  A4.1'n) going to ask you about whal parts of the fish you eat. Please tell me what percentage of Ihe time you eat the following
  categories when you eat fish.
  —READ ALL CATEGORIES FIRST—Please answer 0-100%. Answers 1 & 2 must total 100%.

  1) Fillet with skin:                              	%
  2) Fillet without skin:                            	% 11 & 2 total 100%)
  3) Head, bones, eggs, organs:	% (0-100%)

  AS. The following questions will ask about your eating patterns at social events.  In the last 12 months, how often did you attend
  special celebrations (holiday celebrations, Chinese New Year, cultural or community events, weddings, etc.):
                                                	times

  A6. Please indicate your age	. If you choose not to. please select your age category.
          18-29DI           30-54 D2           55+D3
NJ
00

-------
Appendix K
     129

-------
Appendix K
	 1 	
Types of Seafood Consumed/Respondents Who Consume (%)
Anadromous Fish (%)
salmon
trout
smelt
salmon eggs


Pelaeic Fish
tuna
cod
mackeral
snapper
rockfish
herring
dogfish
snowfish
93
61
45
27


(%)
86
66
62
50
34
21
7
6
Freshwater Fish
catfish
tilapia
perch
bass
carp
crappie

Bottom Fish
halibut
sole/flounder
sturgeon
suckers



(%)
58
45
39
28
22
17

(%}
65
42
13
4



Shellfish
shrimp
crab
squid
oysters
manila/little-
neck clams
lobster
mussel
scallops
butter clams
geoduck
cockles
abalone


(%)
98
96
82
71

72
65
62
57
39
34
21
15


razor clams
sea cucumber
sea urchin
horse clams
macoma clams
moonsnail


Seaweed/Kelp
seaweed
kelp





16
15
14
13
9
4


(%}
57
29






-------
Appendix L
     131

-------
                                      Table. Outliers and Substitution
APPENDIX  L
QX*

aim*
BR: -
FRI5-
JRI •
JVOI-
;v43*
Pelasic
BRIS"
FR13-
JRII'
JV02'
JV43"

CV05~
FR15*
JRIf
IR2&+
JR42+
JV02'
JV43"

BRIS"
CV05+
CV25-"
JV02B
JRIf
JV43"
Shellfish
BRAS"
ER04*
JRII-
JV02*
JV43"

BRIS*
OR22+
DVQ8+
EVQ5+
EV06f
JV02-

BRIS'

DR22+
OVQ8*
ERI3-
JRlf
JV02*
JV4J-

8RI3'
JRII'
JVOI1
JV43-




Lao





Uo


Vietnamese


Lao





























Jaoanese

Vietnamese









F
F
M
M
F
M

F
M
M
F
M

F
M
M
M
M
F
M

F
F
M
F
M
M

F
M
M
F
M

F
F
F
F
F
F

F
F
F
F
M
M
F
M

F
,\t
F
M


5 Us
59 lea
Tilcz
66
Ij
49

57 ka
79 ka
66
45
49 kz

54 kz
75 ka
66
65 k*
54 U
45
49

57 lea
54 kz
63k?
45
66
49

57 ta
73kg
66
45
49 ka

57 Ice
54kg
41ki
59kg
50kg
45
_
57 kz
49 leg
54 ka
43 kz
61 kz
66
45
49

57ksi
00
45
44


< (Ok

25-35 k
< 10 k
<10te
< 10 k

< !0k
1 5-10 k
< 10k
< 10 k
< 10k

< 10k
25-35 k
< 10k
< 10k
< lOlc
45k

-------
Appendix M
      133

-------
                                                                        Appendix M-l-a
                         Participation rates by participant category
Participant    Attempted  Unable to   Reached   Disqualified   Refused   Participated
Category       Contacts    Contact
Volunteer
Roster
150
365
24 (16)
198(54)
126(84)
167 (46)
16(13)
24(14)
 4(4)
47 (33)
106 (96)
96(67)
                                    134

-------
                                           Appendix M-l-b
Miscellaneous seafood consumers
Species # of Consumers % of all respondents 1
Octopus
Eel (freshwater/saltwater)
Fish egg (all kind)
Yellow fish
Bonito Flakes
Milk fish
Jelly fish
Beltfish
Fly fish
Sardine
Galung Gong
Monk fish
Dried small fish
Shad
Shark
Barracuda
Sword fish
23
21
21
19
12
9
8
6
6
4
2
1
1
1
1
1
1
11%
10%
10%
9%
6%
4%
4%
3%
3%
2%
1%
0%
0%
0%
0%
0%
0%
         135

-------
                                                                             Appendix M-2-b




Demographic and seafood preparation characteristics of "higher" and "lower" seafood consumers.
I^^^^^^^^^^^^^H All Finfish Shellfish
n
7emale
Male
18-29
30-54
55+
Cambodian
Chinese
7ilipino
apanese
torean
.aotian
Mien
imong
Satnoan
Vietnamese
3FPL
IS or Less
Above HS
^on-fishermen
107
95
78
85
39
20
30
30
29
22
20
10
5
10
26
71
39
38
39
69
98
136
'ishermen 66
(Higher Consi
1.144
Lower
Consumers
76%
^ 81%
• 85%
79% ;
• 64%
f ,- 90%
1:83% K
V7f 80%'-
- :48%
' 91% X
i 75% ;
* X90%; '^
^noo%- •
" '100%
69%
79%
92%
76%
74%
74%
81%
82%
71%
imer: > 75%tile =
g/day/kg)
Higher
Consumers
24%
19%
15%
21%
36%
10%
17%
20%
52%
9%
25%
10%
0%
0%
31%
21%
8%
24%
26%
26%
19%
. 18%
29%
(Higher Consumer: > 75%tile =
1.072 g/day/kg)
Lower
Consumers
71%
79%
73%
; 78%
72%
' 70% !
'•'.•:•'• 70%' ;
87% "* •'.,
79% ; ,
68%
75%
90%
:-' 100% "
100%
50%
68%
77%
82%
80%
70%
76%
76%
73%
Higher
Consumers
29%
21%
27%
22%
28%
30%
30%
13%
21%
32%
25%
10%
0%
0%
50%
32%
23%
18%
20%
30%
24%
24%
27%
                                         136

-------
Appendix M-2-b
Demographic and seafood preparation characteristics of "higher" and "lower" seafood consumers.
^H^B^^H^^^^^^I AH Finfish Shellfish ^^H

Read in Books
Listen to someone
See Video
Learn on Computer
Tape Recording
See Slide Show
Read Comic book
Fillet with Skin
Fillet w/o Skin
Head/Bone/Organ
Bake, Boil, etc.
Canned, Fried, etc.
Purchased
Caught
(Higher Consu
1.144
Lower
Consumers
(n=158)
65%
54%
39%
d5%
8%
3% :
.5% ;
52% (3%)
41% (3%)
20% (3%)
58% (2%) i
36% (2%)
75%
25%
mer: > 75%tile =
?/day/kg)
Higher
Consumers
(n=44)
84%
59%
23%
18%
7%
7%
2%
51% (6%)
44% (7%)
19% (4%)
72% (4%)
24% (3%)
82%
18%
(Higher Consumer: > 75%tile =
1.072g/day/kg)
Lower
Consumers
(n=151)
72%
55%
36%
15%
7%
3%
3%

76% (2%)
,22% (2%)
86%
14%
Higher
Consumers
(n=51)
61%
55%
33%
18%
10%
8%
10%

79% (3%)
21% (3%)
93%
7%

137

-------
                                 Seafood consumption rates by ethnicity*
                                                                                                        Appendix M-3
1 Category
Anadromous
Fish
(p
-------
                                                                                                                                  Appendix M-3
                                        Seafood consumption rates by ethnicity (continued)
Category Ktlmkity Sample Mean S.K. 10% tile Median 1st 3rd Motile <7< with Consum- 95<7< <>5<7<-UCl|
sue Quartilc Quartile non-/cro crs(%) LCI 1
(n) loiisuinp- 1
lion 1
Seaweed/Kelp
(p
-------
Seafood consumption rates by ethnicity and gender*
                                                           Appendix M-4
IFi male
Category
Anadromous
Fish










Pelagic Fish










Freshwater
fish









Bottom Fish










Ethnicity
Cambodian

Chinese
Filipino
Japanese
Korean
Laotian
Mien
Hmong
Samoan
Vietnamese
All Ethnicity
Cambodian
Chinese
Filipino
Japanese
Korean
Laotian
Mien
Hmong
Samoan
Vietnamese
All Ethnicity
Cambodian
Chinese
Filipino
Japanese
Korean
Laotian
Mien
Hmong
Samoan
Vietnamese
All Ethnicity
Cambodian
Chinese
Filipino
Japanese
Korean
Laotian
Mien
Hmong
Samoan
Vietnamese '
All Ethnicity
n
II

15
15
1?
12
10
5
".3'';.
5 .
14
107
11
|5
15
17
12
10
•5;
3
5
14
107
11
15
15
17
12
10
5
3
5
14
107
n
15
15
17
12
10
5
3
5
14
107
Mean
0.040

0.292
0.173
0.362
0.079
0.122
0.011
o;o78
6.066
0.091.
0.165
0.118
0.421
0.428
0.515
0.265
0.311
O.J59
; 0.083
0.545
0.325
0.349
0.125
0.068
0.157
0.026
0.012
0.344
0.145
0.169
0.026
0.276
0.13!
0.056
0.132
0.243
0.161
0.077
0.086
0.004
0.045
0.030
0.089
0.115
SE
0.023

0,094
0.047
0.060
0.024
0.060
0.005
0.006
0.016
.0.035
0.022
0.033
0.117
0.151
0.070
0.072
,0.120
0.154
0.049
0.021
0.096
O.OJ7
0.056
0.024
0.065
0.007
0.007
0.117
0.075
0.084
0.010
0.081
0.021
0.044
0.047
0.080
0.040
0.024
0.061
0.003
0.034
0.008
0.057
0.019
Median
0.015

0.086
0.103
0.250
0.054
0.042
0.009
0.074
0.066
0.051
0.076
0.074
0.214
.0.247.
: 0.398
0.178
0.111
0.005
0.043
0.559
0.188
0.215
0.048
0.033
0.091
0.012
0.000
0,168
0,072
0.091
0.033
0.128
0.054
0.000
0.054
0.119
0.099
0.048
. 0.003
0.000
0.024
0.025
0.014 .
0.040
n
9

15
15
12
10
10
5
2
5
12
95
9
15
15
12
10
10
5
2
5
12
95
9
15
15
12
10
10
5
2
5
12
95
9,
15
15
12
10
10
5
2
5
12
95
Malt
Mean
0.214

0.093
0,132
0.392
0.107
0.253
0.025
0.029
0.068
0.162
0.169
0.051
0.229
0.206
0.663
0,371
0.513
0.055
0.107
0.453
0.439
0.334
0.156
0.101
0.107
0.014
0.057
0.221
0.050
0.078
0.026
0.417
0.137
0.032
0.031
0.087
0.191
0,169
0,046
0.008
0.021
0028
0,118
0087
SE
0.102

0.035
0.026
0.107
0.052
0.113
0.016
0.002
0.032
0.036
0.024
0.016
0.063
0.053
0.164
0.089
0.253
0.033
0.017
0.122
0.151
0.043
0.077
0.040
0.025
0.009
0.030
0.102
0.014
0.003
0.010
0.101
0.023
0.016
0.014
0.015
0.093
0.047
0.018
0.006
0.021
0.007
0.069
0.017
Median
0.088

0.031
0.097
0.309
0.043
0.108
0.014
0.029
0.050
0.141
0,080
0.045
0.122
0.117
0,566
0,391
0.115
0.023
0.107
0.518
0.222
0.148
0,042
0,008
0.070
0.000
0.015
0.077
0.050
0,078
0,025
0.324
0,054
0.006
0.014
0.091
0.051
0.156
0.010
0.000
0.021
0.026
0.033
0.034
                     140

-------
Seafood consumption rates by ethnicity and gender (continued)
                                                               Appendix M-4
IFiraak
Category
Shellfish Fish










Seaweed/Kelp










Miscellaneous
Fish









AIIFinfish










Ethnicity
Cambodian
Chinese
Filipino
Japanese
Korean
Laotian
Mien
Hmong
Samoan
Vietnamese
All Ethnicity
Cambodian
Chinese
Filipino
Japanese
Korean
Laotian .^
Mien '[',
Hmong
Samoan
Vietnamese
All Ethnicity
Cambodian
Chinese
Filipino
Japanese
Korean
Laotian
Mien
Hmong
Samoan
Vietnamese
All Ethnicity
Cambodian
Chinese
Filipino
Japanese
Korean
Laotian
Mien
Hmong
Samoan
Vietnamese
All Ethnicity
n
'I
15
15
17
12
10
• 5 '',-•
.,3 ;'; '--.'-'•
5 •• ' '.•''•'
'.- 14 "--' - i':-\
;u>7 ••'
.-",.•-// .V
' I5 "•-.••
,15 .- . -.,.'.. :
17 ; .-;
12
•'°\rS
iiSV^V'
3:^v.!;'; •
' 5 • •':-.•:;.
14
107
11
15
15
17
12
10
5
3
5
14
107
11
15
15
17
12
10
5
3
5
14
107
Mean
0.715 .
1.115
0.689
0.524 .
0.858
1.088
0.311
0.266
0.191
..1725 v
0.864
0.002
0.076
0.005
0.241 '."-
0.242
0.006.:
o!ooo /:
0.003
0.000
0.010
0.079
0.108
0.080
0.094
0.253
0.062
0.084
0.002
0.003
0.069
0.084
0.105
0.338
0.912
1.001
1.063
0.432
0.862
0.318
0.375
0.666
0.781
0.759
SE
0.184
0.259
0.118
0.101
0.216
0.326 •;
0.129
0.007
.1. .0.043
OJ65
. 0.086
.-,.-• .Q.ooi ..
0.014
0.003
0.068
0.083 ..!
v : 0-005
..':.';• 0.000
" 0.001
0.000
0.007
0.018
0.034
0.029
0.040
0.046
0.015
0.027
0.001
0.002
0.025
0.014
0.013
0.129
0.225
0.275
0.126
0.104
0.228
0.236
0.116
0.025
0.227
0.071
Median
0.404
0.768
0.789
0.372
0.430
0.692
0.214 .
0.271 ;
0.168
1.772 " '
0.432 '"•;..-
0.000
0.018
0.000
0.101
.'- 0.087;;
".-' o.oop ;.:':,
0.000 .
0.004
0.000
0.000
0.005
0.071
0.029
0.037
0.258
0.047
0.054
0.001
0.001
0.050
0.087
0.061
0.188
0.371
0.462
1.070
0.339
0.722
0.092
0.288
0.692
0.384
0.512
n
9
15
15
12
10
10
5
2
5
12
95
9
15
15
12
10
10
5
2
5
12
95
9
15
15
12
10
10
5
2
5
12
95
9
15
15
12
10
10
5
2
5
12
95
Male |
Mean
1.168
0.855
0.538
0.712
1.270
0.709
0.365
0.221
0.116
1.405
0.836
0.002
0.047
0.013
0.118
0.149
0.002
0.000
0.001
0.000
0.026
0.044
0.119
0.082
0.072
0.237 .
0.128
0.064
0.028
0.042
0.082
0.094
0.104
0.453
0.454
0.531
1.259
0.703
1.032
0.137
0.235
0.575
1.135
0.726
SE
0.426
0.216
0.060
0.162
0.496
0.412
0.201
0.024
0.010
0.379
0.104
0.002
0.030
0.007
0.036
0.048
0.001
0.000
0.001
0.000
0.026
0.010
0.044
0.030
0.030
0.058
0.065
0.035
0.014
0.033
0.054
0.023
0.015
0.156
0.121
0.083
0.245
0.108
0.349
0.041
0.033
0.117
0.258
0.072
Median 1
0.843
0.497
0.498
0.468
0.555
0.373
0.127
0.221
0.113
0.946
0.490
0.000
0.017
0.004
0.066
0.114
0.000
0.000
0.001
0.000
0.000
0.002
0.088
0.036
0.046
0.177
0.041
0.021
0.016
0.042
0.023
0.076
0.055
0.321
0.241
0.437
1.217
0.618
0.740
0.099
0.235
0.620
0.721
0.458
                          141

-------
                 Seafood consumption rates by ethnicity and gender (continued)
                                                                                       Appendix M-4

1 Category Ethnicity
All Fish Cambodian
Chinese
Filipino
Japanese
Korean
Laotian
Mien
Hmong
Samoan
Vietnamese

All Ethnicity
All Seafood Cambodian
Chinese
Filipino

Japanese
Korean

Laotian
Mien
Hmong
Samoan
Vietnamese
All Ethnicity

n
II
15
15
17
12
10
5
3
5
14
I
107
11
|5
15

17
12

10
•5.
3
5
14
107

Mean
1.161
2.108
1.784
1.840
1.351
2.034
0.631
0.644
0.927
2.589
,, .. ,f
1.728
1.163
2.184
1.789

2.081
1.593
X * ' •- '
2.040
0.631
0.647
0.927
2.599
1.807
-i male
SE
0.318
0.458
0.386
0.214
0.283
0.472
.0.360
0.108
0.039
0.485

0.135
0.318
0.479
0.386

0349
0.330

0.470
0.360
0.106
0.039
0.488
0.139
Male
Median
0.799
1.542
1.370
1.723
0.819
1.675
0.296
0.560
0.896
2.494

1.328
0.799,
1.663
1.417
. -.- . i.
1.830
0.893
1 • v
1.675
0396
0.564
0.896
2.494
.1.417
n
9
15
15
12
10
10
5
2
5
12

95
9
15
15

12
10

10
5
2
5
12
95
Mean
1.739
1.390
1.140
2.208
2.101
1.805
0.530
0.497
0.774
2.634

1.666
1.742
1.437
1.153

2.325
2.251

1.807
0.530
0.498
0.774
2.660
1.710
SE
0.468
0.320
0.109
0.424
0.486
0.557
0.195
0.024
0.152
0.613

0.149
0.468
0.329
0.113

0.437
0.509

0.557
0.195
0.024
0.152
0.611
0.152
^^^^B
1.353
0.753
0.994
1.794
1.670
1.205
0.272
0.497
0.732
1.911

1.202
1.353
0.757
0.994

1.860
1.686

1.205
0.272
0.498
0.732
2.065
1.257
No weight applied.
*AII consumption rates in g/kg bodyweighl/d.
                                             142

-------
                           Seafood consumption rates by age*
                                                                              Appendix M-5
Category
Anadromous Fish
(p=0.001)

Pelagic Fish (p=0.3)


Freshwater Fish
(P=0.3)

Bottom Fish (p=0.9)


Shellfish Fish
(P=0.6)

Seaweed/Kelp
(p=0.9)

Miscellaneous seafood
(P=0.4)

All Finfish (p=0.4)


All Fish (p=0.6)


All Seafood (p=0.6)


Age Group
18-29
30-54
55+
18-29
30-54
55+
18-29
30-54
55+
18-29
30-54
55+
18-29
30-54
55+
18-29
30-54
55+
18-29
30-54
55+
18-29
30-54
55+
18-29
30-54
55+
18-29
30-54
55+
n
78
85
39
78
85
39
78
85
39
78
85
39
78
85
39
78
85
39
78
85
39
78
85
39
78
85
39
78
85
39
Mean
0.134
0.164
0.237
0.387
0.287
0.372
0.098
0.134
0.206
0.102
0.099
0.105
0.862
0.795
0.950
0.050
0.056
0.102
0.119
0.096
0.094
0.721
0.684
0.919
1.702
1.575
1.964
1.752
1.631
2.065
SE
0.024
0.027
0.037
0.053
0.035
0.071
0.016
0.023
0.053
0.022
0.016
0.034
0.105
0.088
0.198
0.014
0.014
0.035
0.018
0.013
0.021
0.075
0.072
0.145
0.152
0.138
0.293
0.155
0.144
0.296
Median
0.065
0.073
0.151
0.265
0.140
0.172
0.045
0.056
0.072
0.036
0.031
0.043
0.505
0.490
0.367
0.002
0.004
0.001
0.061
0.055
0.037
0.577
0.443
0.476
1.319
1.206
1.352
1.370
1.217
1.427
75%tile
0.130
0.201
0.305
0.504
0.443
0.689
0.111
0.117
0.156
0.123
0.124
0.103
1.087
1.058
1.482
0.037
0.028
0.073
0.146
0.124
0.117
0.966
0.966
1.434
2.055
2.223
2.993
2.147
2.299
3.217
90%tile 1
0.399
0.428
0.537
0.814
0.742
1.063
0.277
0.368
1.032
0.191
0.261
0.202
1.645
1.996
3.247
0.205
0.219
0.387
0.340
0.277
0.278
1.312
1.424
2.456
3.914
3.162
5.241
3.916
3.841
5.241
*A11 consumption rates in
Note: P-value is based on
g/kg bodyweight/d.
Kruskal Wallis Test. No weight applied
                                         143

-------
                         Seafood consumption rates by income*
                                                                              Appendix M-6
Category
Anadromous Fish
(p=.036)


Pelagic Fish (p=0.5)



Freshwater Fish
(p=0,6)


Bottom Fish (p=0.007)



Shellfish Fish (p^O.7)



Seaweed/Kelp
(p=0.001)


Miscellaneous seafood
(p=0.062)


All Finfish (p=0.3)



All Fish (p=0.6)



All Seafood (p=0.6)



Income Group
Under FPL**
1.0 -2.0 FPL
2.0 -3.0 FPL
>3.0FPL
Under FPL
1.0 -2.0 FPL
2.0 -3.0 FPL
>3.0 FPL
;Under FPL
fh()-:2.bFPL
f2.0-/3.6FPL
I>3#FPL"
Under FPL
1.0 -2.0 FPL
2.0 - 3.0 FPL
>3.0 FPL
£UnderFPL
[iJipfrFPL
<2j6>3lb FPL
>3X)FPL
Under FPL
1.0 -2.0 FPL
2.0 -3.0 FPL
>3.0 FPL
Under FPL
1.0 -2.0 FPL
2.0 - 3.0 FPL
>3.0 FPL
Under FPL
1.0 -2.0 FPL
2.0 -3.0 FPL
>3.0 FPL
Under FPL
1.0 -2.0 FPL
2.0 - 3.0 FPL
>3.0 FPL
Under FPL
1.0 -2.0 FPL
2.0 - 3.0 FPL
>3.0 FPL
n
71
39
38
39
71
39
38
39
71
39
38
39
71
39
38
39
71
39
38
39
71
39
38
39
71
39
38
39
71
39
38
39
71
39
38
39
71
39
38
39
Mean
0.121
0.094
0.196
0.211
0.352
0.265
0.381
0.310
0.196
0.090
0.128
0.105
0.094
0.086
0.070
0.141
0.984
:0.832
0.750
:6.766
0.031
0:049
0.081
0.053
0.072
0.087
0.125
O.Q88
0.763
0.535
0.774
0.768
1.819
1.453
1.649
1.622
1.850
1.502
1.731
1.674
SE
0.021
0.013
0.043
0.044
0.048
0.063
0.087
0.049
0.035
0.018
0.029
0.030
0.025
0.022
0.019
0.033
0.140
0^154
0.095
0.133
0.013
0.016
0.030
0.017
0.012
0.020
0.023
0.017
0.097
0.086
0.118
0.108
0.208
0.202
0.178
0.193
0.209
0.208
0.189
0.196
Median
0.049
0.074
0.086
0.119
0.182
0.104
0.172
0.194
0.069
0.056
0.066
0.052
0.017
0.037
0.030
0.095
0.386
0.424
0.535
0.516
0.000
0.008
0.005
0.005
0.032
0.060
0.068
0.044
0.441
0.364
0.489
0.458
1.029
0.894
.364
.328
.029
0.906
.427
.425
75%tile
0.107
0.108
0.251
0.264
0.553
0.340
0.441
0.513
0.259
0.093
0.154
0.097
0.071
0.111
0.088
0.154
1.455
0.973
0.987
1.056
0.005
0.030
0.036
0.034
0.091
0.112
0.171
0.126
0.925
0.805
1.126
1.210
2.529
1.838
2.450
2.003
2.565
1.859
2.450
2.055
90%tile
0.468
0.249
0.618
0.551
0.865
0.676
0.825
0.775
0.749
0.336
0.449
0.334
0.180
0.222
0.191
0.324
3.187
2.029
1.441
1.482
0.048
0.219
0.261
0.207
0.178
0.202
0.295
0.206
2.072
1.099
1.798
1.467
4.494
3.162
3.159
3.909
4.496
3.162
3.522
3.909
*A11 consumption rates in g/kg bodyweight/d.
* * FPL—Federal Poverty Level
Note:  15 respondents with unknown income are excluded in this table. P-value is based
on Kruskal Wallis Test. No weight applied.
                                         144

-------
                        Seafood consumption rates by education*
                                                                            Appendix M-7
Category

i 	 • -=™^DSE^"™=^=^=*3SS=^=X^=^=^^^
Anadromous Fish
(P=0.7)
Pelagic Fish
(P=0.3)
Freshwater Fish
(p=0.000)
Bottom Fish
(P=0.1)
Shellfish Fish
(p=0.6),
Seaweed/Kelp
(p=0.001)
Miscellaneous seafood
(p=0.045)
All Finfish
(p=0.068)
All Fish
(P=0.6)
All Seafood
(P=0.8)
Education
Level
HS
HS
HS
HS
HS
HS
HS
HS
HS
HS
mM
69
98
69
98
69
98
69
98
69
98
69
98
69
98
69
98
"69
98
69
98
Mean
•Hi
0.1657
0.1605
0.3913
0.3183
0.2072
0.1031
0.0892
0.1340
0.9039
0.8904
0.0409
0.0763
0.0881
0.1057
0.8535
0.7160
1.8455
1.7120
1.8864
1.7883
SE

0.027
0.023
0.051
0.040
0.031
0.021
0.019
0.022
0.114
0.101
0.017
0.016
0.016
0^013
0.087
0.075
'0.182
0.145
0.183
0.151
Median
^^^^H
0.0720
0.0797
0.2659
0.1567
0.0890
0.0332
0.0295
0.0603
0,4473
0.4983
0.0000
0.0053
0.0320
0.0644
0.6141
0.4213
1.4628
1.2535
1.4812
1.2676
75%tilc 90%tilc|
^^^^H
0.2261
0.1642
0.6306
0.4337
0.2700
0.0952
0.1173
0.1383
1.4988
1.0706
0.0082
0.0490
0.1070
0.1360
1.2440
0.9644
2.5540
2.2109
2.5960
2.4464

0.4978
0.4306
0.8652
0.8440
0.5898
0.2137
0.1911
0.3550
2.2534
2.5680
0.0988
0.3218
0.2346
0.2775
1.9357
1.5971
4.1507
3.9282
4.1507
4.0798
*A11 consumption rates in g/kg bodyweight/d.
**HS—High School
Note: P-value is based on
Mann-Whitney Test. No weight applied.
                                        145

-------
                  Seafood consumption rates by roster and volunteer*
                                                                            Appendix M-8
Category
Anadromous Fish (p=0.4)

IPelagic Fish (p=0.6)

(Freshwater Fish (p=0.6)

iBottom Fish (p=0.3)

Shellfish Fish (p=0.4)

Seaweed/Kelp (p=0.2)

Miscellaneous seafood
(p=0.07)
All Finfish (p=0.4)

All Fish (p=0.5)

All Seafood (p=0.5)

Resource
Roster
Volunteer
Roster
Volunteer
Roster
Volunteer
Roster
Volunteer
Roster
Volunteer
Roster
Volunteer
Roster
Volunteer
Roster
Volunteer
Roster
Volunteer
Roster
Volunteer
n
96
106
96
106
96
106
96
106
96
106
96
106
96
106
96
106
96
106
96
106
Mean
0.148
0.184
0.324
0.359
0.142
0.126
0.085
0.116
0.873
0.831
0.045
0.079
0.091
0.117
0.698
0.785
1.662
1.733
1.707
1.811
SE
0.022
0.024
0.041
0.041
0.025
0.020
0.016
0.019
0.109
0.081
0.012
0.017
0.013,
0.014
0.070
0.072
0.149
0.135
0.152
0.139
Median
0.074
0.082
0.175
0.205
0.057
0.049
0.029
0.043
0.422
0.494
0.002
0.005
0.034
0.068
0.452
0.494
1.129
1.409
1.206
1.477
75%tile
0.170
0.228
0.457
0.493
0.131
0.142
0.098
0.137
1.020
1.152
0.027
0.065
0.130
0.137
0.936
1.112
2.085
2.404
2.284
2.586
90%tile
0.337
0.503
0.829
0.826
0.430
0.366
0.195
0.289
2.289
1.811
0.134
0.312
0.260
,0.315
1.512
1.738
4.004
3.899
4.020
3.986
*A11 consumption rates in
Note: P-value is based on
g/kg bodyweight/d.
Mann-Whitney Test. No weight applied.
                                      146

-------
Seafood source by ethnicity
                                                 Appendix M-9
| Fish Source I
Groeery/V cndor (%)
Caught in King County
Caught outside King
Restaurants (•/•)
" ' ' (%) '; ' Coun1y(%)
CategoT
AnadromousFish










Pelagic Fish










Freshwater Fish










Bottom Fish










Shellfish Fish










Ethnicity
Cambodian
Chinese
Filipino
Japanese
Korean
Laotian
Mien
Hmong
Samoan
Vietnamese
All Ethnicity
Cambodian
Chinese
Filipino
Japanese
Korean
Laotian
Mien
Hmong
Samoan
Vietnamese
All Ethnicity
Cambodian
Chinese
Filipino
Japanese
Korean
Laotian
Mien
Hmong
Samoan
Vietnamese
All Ethnicity
Cambodian
Chinese
Filipino
Japanese
Korean
Laotian
Mien
Hmong
Samoan
Vietnamese
All Ethnicity

Chinese
Filipino
Japanese
Korean
Laotian
Mien
Hmong
Samoan
Vietnamese
All Ethnicity
n
18
30
29
29
22
18
7
5
10
26
194
17
30
30
29
22
20
7
5
10
26
196
18
24
30
20
13
18
10
5
9
26
173
10
28
27
28
18
14
4
3
10
21
163

30
30
29
22
. 19
10
5
10
26
201
Mean
71%
"68%
77%
65%
170%
-63%
44%
65%
•43%
?84%
69%
83%
61%
78%
61%
95%
93%
,«%
85%
<55%
88%
. i77%
67%
73%
82%
40%
49%
66%
13%
70%
20%
79%
62%
73%
60%
64%
59%
97%
38%
0%
83%
18%
66%
61%
78%
50%
76%
54%
80%
76%
64%
89%
43%
72%
67%
SE
9%
5%
'5%
5%
9%
8V
15%
19%
9%
;5% .
2%
7%
6%
5%
•7%
J%
A%
18%
.10%
;7%
"4%'
2%*
8%
7%
6%
9%
14%
9%
10%
20%
8%
6%
3%
13%
8%
7%
7%
3%
13%
0%
17%
7%
10%
3%
6%
5%
5%
6%
6%
6%
14%
7%
4%
7%
2%
Mean
7%
3%
4%
6%
2%
13%
30%
35%
3%
3%
7%
7%
0%
1%
2%
2%
6%
28%
15%
2%
3%
4%
14%
0%
4%
11%
45%
18%
68%
30%
17%
3%
15%
13% .
4%
1%
6%
3%
10%
25%
17%
0%
23%
8%
. 9%
7%
7%
12%
16%
7%
29%
7%
2%
5%
9%
SE
4%
1%
1%
3%
1%
5%
14%
19%
3%
2%
1%
4%
0%
1%
1%
2%
4%
18%
10%
2%
1%
1%
7%
0%
2%
7%
13%
7%
13%
20%
12%
2%
2%
9%
2%
1%
3%
3%
7%
25%
17%
0%
9%
2%
5%
2%
3%
4%
6%
4%
12%
5%
2%
2%
1%
Mean
16%
4%
11%
6%
18%
12%
.24%
0%
8%
0%
9%
3%
1%
10%
0%
0%
6%
7%
0%
20%
1%
- '3%
10%
0%
5%
0%
4%
9%
18%
0%
40%
0%
6%
0%
5%
10%
9%
0%
33%
' 75%
0%
13%
0%
9%
0%
1%
3%
0%
2%
0%
5%
0%
29%
0%
2%
SE
8%
2%
4%
3%
8%
8%
14%
0%
5%
0%
2%
2%
0%
5%
0%
0%
0%
7%
0%
7%
1%
1%
6%
0%
4%
0%
4%
6%
11%
0%
12%
0%
2%
0%
4%
5%
5%
0%
12%
25%
0%
9%
0%
2%
0%
1%
3%
0%
1%
0%
5%
0%
6%
0%
1%
Mean
6%
25%
8%
24%
10%
12%
1%
0%
47%
13%
16%
8%
38%
11%
37%
2% '
2%
0%
0%
14%
9%
16%
9%
27%
9%
49%
2%
8%
1%
0%
23%
17%
17%
10%
31%
26%
27%
0%
20%
0%
0%
70%
10%
22%
12%
41 %
15%
34%
3%
17% .
3%
4%
27%
23%
21%
SC
4%
4%
2%
5%
5%
4%
1%
0%
9%
5%
2%
5%
6%
3%
7%
2%
1%
0%
0%
4%
4%
2%
5%
7%
4%
9%
2%
• 6%
1%
0%
11%
5%
2%
15%
8%
6%
6%
0%
9%
0%
0%
13%
7%
3%
'5%
5%
3%
5%
1%
5%
3%
4%
3%
6%
2%
           147

-------
Seafood source by ethnicity (continued)
                                                       Appendix M-9
Fish Source
Grocery/Vendor (%)
Seaweed/Kelp Cambodian
Chinese
Filipino
Japanese
Korean
Laotian
Mien
Hmong
Samoan
Vietnamese
All Ethnicity
7
29
IS
29
21
7
0
3
0
5
116
64%
71%
86%
82%
90%
89%
0%
100%
0%
84%
81%
18%
7%
8%
4%
5%
11%
0%
0%
0%
10%
3%
Caught in King County
('/.)
0%
1%
12%
0%
7%
0%
0%
0%
0%
0%
3%
0%
1%
8%
0%
5%
0%
0%
0%
0%
0%
1%
Ought outside King
County (•/.)
0%
0%
1%
0%
0%
0%
0%
0%
,0%
0%
0%
0%
0%
1%
0%
0%
0%
0%
0%
0%
0%
0%
Restaurants (%)
36%
28%
2%
18%
2%
11%
0%
0%
0%
16%
16%
18%
7%
1%
4%
2%
11%
0%
0%
0%
10%
3%
               148

-------
                                                                                                                      Appendix M-10
                            Comparison between original survey and re-interview responses on selected questions
! SaltJftn I Halibut 1 Shrimp I Finfish Parts Cor sum*] 1 Auadnmious Fish 1 Shellfish
#of
servings
/year
"i~~] if
0
9
21
6
8
6
8
6
6
48"
48
60
6
6
12
1 I
4 1
' 3
15
13
3
20
40
...._
14
T
18
12"
24
44
60
52
6
8
2
7
4
i
8
1
#of
servings
/year
"TTir
0
6
8
I
2
1
12
2
3
6
12
36
12
0
0
0
0
3
14
24
5
6
8
0
3
0
12
12
3
18
24
5
18
8
0
0
0
2
0
1
#of
servings
/year
I ^
315
12
8
15
8
56
15
104
12
6
12
60
18
48
12
2
10
5
30
76
II
24
24
22
8
52
52
24
52
12
18
48
60
12
17
10
2
24
2
4
8
Fillet
with
Skin
I
100
80
50
100
0
100
75
75
25
5
0
0
20
0
0
10
100
0
80
25
II
100
100
80
25
80
80
0
100
60
100
0
98
50
50
80
0
20
0
50
50
Fillet
without
Skin
I
0
20
50
0
100
0
25
25
75
95
100
100
80
0
100
90
0
100
20
75
II
0
0
20
75
20
20
100
0
40
0
100
2
50
50
20
100
80
100
50
50
Head,
bone,
egg.
organ
I
100
20
5
0
20
95
0
75
50
0
0
0
0
0
10
0
0
0
100
5
II
50
30
0
0
10
50
0
10
10
0
0
0
0
0
0
7
0
0
10
10
Purchase
from
Groceries
I
30
100
100
85
25
90
75
100
75
85
100
80
50
100
90
100
50
0
99
90
II
80
100
85
50
50
80
90
100
70
70
80
100
50
100
100
100
100
0
100
100
Caught
in
King
County
I
0
0
0
0
25
10
10
0
25
0
0
0
25
0
10
0
20
0
0
3
II
0
0
0
0
0
20
0
0
10
0
0
0
50
0
0
0
0
50
0
0
Caught
outside
King
County
I
70
0
0
0
25
0
0
0
0
5
0
0
0
0
0
0
30
50
0
2
II
20
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
50
0
0
Consumed
at
Restaurants
I
0
0
0
15
25
0
15
0
0
10
0
20
25
0
0
0
0
50
1
5
II
0
0
15
50
50
0
10
0
20
30
20
0
0
0
0
0
0
0
0
0
Purchased
from
Groceries
I
100
100
80
50
34
90
90
90
50
80
95
70
100
100
90
100
100
50
95
70
II
100
50
80
25
50
100
95
90
70
75
70
85
100
100
100
100
100
0
100
50
Caught
in
King
County
I
0
0
0
20
33
0
5
0
50
10
0
10
0
0
0
0
0
0
0
0
II
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Caught
outside
King County
I
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
25
0
0
II
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
50
0
0
Consumed at
Restaurants
I
0
0
20
30
33
10
5
10
0
10
5
20
0
0
10
0
0
25
5
30
II
0
50
20
75
50
0
5
10
30
.25
30
15
0
L °
0
0
0
50
0
50
vO
              Note: I = survey response; II = re-interview response.

-------
Appendix N
      150

-------
                                                                                Appendix N-l
  LIST OF FIFTEEN SEAFOOD RELATED HEALTH CONCERNS HELD BY ADVISORY AND TECHNICAL COMMITTEE
       MEMBERS WHICH WERE LATER RANKED BY CSC MEMBER'S PERCEIVED IMPORTANCE OF THE ISSUE TO
       THE APA COMMUNITY.
    Seafood Health Concerns
     Cited by Advisory' and
     Technical Committee
          • Members
  Safe fishing practices

  Risks from eating seafood

  Ways to reduce health risk
  associated with seafood
  Seafood from foreign markets
  Sensitive populations

  Chemical contaminants

  How to determine safe  seafood
  and fish
  Safe seafood

j  Preservation of fish and
  seafood
  Health effects of chemical
  contaminants
  Environmental quality
  Fishing resources

  Biological contaminants
  Emphasize the health benefits
  of eating seafood
  Reduce fear in the community
  of "uniformed" officials
               Example
Percentage   Percentage of
Safe fishing locations, do not fish near
sewers, posted warning signs
Red tide, PSP (Paralytic Shellfish
Poisoning)
Safe cooking preparations, removing
unsafe parts of fish (liver, guts,...)
What risks are there buying from markets?
Pregnant women, children

Mercury, pesticides, other poisons

Visible signs, odor of seafood

Which seafoods are safe to eat

Proper refrigeration, bacteria
contamination in raw seafood or water
How much fish can be eaten without
getting sick
How to improve healthy seafood growth
Limitations on how many fish or clams to
collect
E. Coli, bacteria
Seafood monitoring police or Fish and
Wildlife officials
                                          of CSC
                                        Members*
             Technical and
               Advisory
               Committee
               members
69*
63*
50*
50*
38*
38*
38*
31
25
25
19
19

19
19
63
50
75
13
25
38
25
50
25
38
13
13

50
13
                   13
 *Top six health concerns cited by the CSC Committees.
    4Each CSC member (n= 16) selected the five they felt to be most important for the APA from the list of 15
                         concerns listed by the Advisory and Technical committees
                                      151

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Appendix N-2 shows the draft brochure which was evaluated using the Focus
Group Questionnaire (Appendix N-3).
                                    152

-------
          For More

   Information
       About Seafood:

        Community
          Contacts

 •Refugee Federation Service Center
  (RFSC).
  Bilinsua! semces available.
  206-725-91 SI
 •Wilderness-Inner City Leadership
  Development (WILD) Project at
  International District Housing
  Alliance (IDHA).
  206-623-5132
 •People for Puaet Sound
  206-382-7007"

      Public Health
         Contacts

 •County Health Departments
  •KJng'County       206-296-47S4
  •Snohomish County 425-S39-5250
 Washington State Dept. of Health
 Consumer Assistance Hotline
 1-SS8-5S6-9427
 Red Tide Information Line
  1-800-562-5632
  J.S. Environmental Protection
  Ksency
 1 -800-424-43 72
•Environmental  Risk Information
 Service. University of Washington
 206-616-7557
A Friendly Health Message
   About Eating Seafood
            From the
         -Puget Sound-
    Is   Good
   far   You!
 But did you know that it
    can also harm  you?
 Tv% an effort 10. understand ihe unique risks faced by ihe Asian Pacific American
 JLll community, a study was conducted by the refugee Federation Service Center
 and the University of Washington's Department of Environmental Health.  For more
 information about the study, contact the Refugee Federation Servicc_Center or the
 University of Washington (see For More Information page).
                                                  Risks From
                                             Eating Bad Seafood

                                        Biological contaminants cause many
                                        illnesses: hepatitis, diarrhea and PSP.
                                        PSP (Paralytic Shellfish Poison) or "Red
                                        Tide" is a poison.  You may have
                                        tingling or numbness on your lips.
                                        tongue, neck, fingers or toes if you have
                                        PSP poisoning.  In worse cases, you may
                                        have breathing problems and trouble
                                        movina vour bodv.
Call to seek medical
attention immediately if
you experience these
problems. This problem
can be life threatening.
Eating too much seafood contaminated
with chemicals can lead to the build-up
of chemicals in your body. This may
increase your risk for:
 •Cancer
 • Kidney Damage
 • Brain Damage, and the
 •Ability to have healthy children.
                                              Contaminants

                                       There are 2 kinds of contaminants:
                                         biological
                                                                                         and chemical
                                                                                         contaminants.
Biological contaminants are bacteria,
parasites, viruses, and fish poisons.
Fish poisons are caused by the food
the seafood eat.

Industries, farms, and sewers all
contribute to the pollution that affects
your seafood. Fish that live close to
these sources of pollution are often
the most affected.

Examples of chemical contaminants
include mercurvjead, and PCBs.

-------
    Who is affected toy
   eating  contaminated
          seafood i*

Everybody!!!!
But...

 •Pregnant women and
  their unbom children
 • Children of any aee


 • Elderly
 •People
  with
  medical
  problems,
  especially liver
  disease,
  diabetes, and
  problems with
  the immune
  system

  arc more sensitive and should be
  more careful about eating
  contaminated s-eatood.
                        Here's  How  to  Protect  Yourself
 1
 Know what types of seafood
 are more likely to cause
 problems:
 • Older and larger fish have more
  chance to store up toxins than younger.
  smaller fish

 •Fish that live at the bottom of the
  water and shellfish tend to have more
  contaminants

 • Some parts of the seafood may have
  higher amounts of contaminants, for
  instance, the "butter" of crabs is higher
  in toxins than the meal

 •Some  species have special risks. For
  example, poison from germs on
  spoiling tuna may cause allergic
  reactions.
2
 Know where your seafood
came from.
 •Use safe fishing practices.
  Washington State will provide safety
  information to vou.

 • Pay attention to warning sisns at the
  beaches and piers.

 •Check with the Washington State
  Department of Health for safe and
  open fishing locations.
3
Use safe preparation practices
                                    •Check to see if your fish is spoiling
                                     before you eat it. A strong fishy smell,
                                     softening of the meat, and hazy eyes
                                     on fish can be signs of bad fish.

                                    • Keep raw fish away from other foods
                                     being prepared

                                    •Proper refrigeration after catching, and
                                     cooking  all fish and shellfish before
                                     eating can kill most of the germs that
                                     can make you sick, but not all of them.

                                    • Cooking does not get rid of "red tide"
                                     or Paralytic Shellfish Poison (PSP).
                                     You can  not tell from the color of the
                                     water or  the seafood if it has PSP.
                                   For an updated recorded message of
                                   beaches closed due to PSP or "red tide,
                                   call the PSP Hotline ai:
                                              1-800-562-5632

                                   For a list of beaches closed for health
                                   reasons, call the King County Health
                                   Dcpar'.menl ai:
                                              106-296-4112.
                                                                                                                        •Remove the guts of the fish.
                                                                                                                         Chemicals build-up in them
                                         • Remove the skin of the fish or
                                          poke holes in the skin. This lets
                                          the fai dram out and
                                          reduces the chemicals
                                          in the fish


                                         •After cooking,
                                          throw out the
                                          remaining fat
                                          and juice from
                                          the fish (the fats
                                         and juices may
                                         have chemical
                                          coniaminanonV

-------
                                                                       Appendix N-C
              Asian and Pacific Islander Seafood Consumption Study
                            Focus Group Testing
                           Evaluation Questionnaire
 Date_
 Name
 Please circle your ethnicity

 Cambodian  Chinese     Filipino     Hmong     Japanese    Korean
 Lao         Mien       Samoan     Vietnamese

 Please evaluate the following categories based on your judgement of the Asian and
 Pacific Islander Consumption Study Questionnaire. Please take your time. If you have
 any questions, please ask the E.P.A. Project Coordinator.
 CONTENT

 1. Do you feel the questions are intrusive or insensitive?    YES   NO

 If yes, please state your reason(s) why and which questions seem intrusive or
 insensitive.
Please rate the length of the questionnaire.

LONG      AVERAGE        SHORT

FORMAT

Do the questions flow logically and smoothly section to section?

ALWAYS    SOMETIMES      NEVER

a.     If "SOMETIMES" or "NEVER," please state your reason(s) why and which
question(s) should be rearranged?	
                                   155

-------
  WORDING/LANGUAGE/TRANSLATION

  I.  Is the use of language clear and concise? Do the questions read easily?

  ALWAYS         SOMETIMES            NEVER

  2.  Is the translation thorough and accurate enough?       YES  NO

 PRESENTATION AND USE OF THE VISUAL DISPLAYS

  1.  Are the usage of the visual displays (seafoods) effective and helpful in answering the
 questions?

 YES   NO

 a. If no, please state your reason(s) why.	        •	
 2. Are the visual displays of seafood easily identifiable?

 YES  NO

 a. If no, please state your reason(s) why.__	

 3. Are the use of the maps effective?

 YES  NO

 a. If no, please state your reason(s) why.	

 MISCELLANEOUS

 I. Are there any other recommendations which should be made to improve the
 questionnaire?

 2. Overall, how would you rate the questionnaire?

 EXCELLENT      GOOD      AVERAGE        POOR
Thank you very much for your cooperation and participation in the
Asian and Pacific Islander Seafood Consumption Study.
                                  156

-------
                                                                              APPENDIX  N4
  TABLE R-15 DESCRIBES THE ANALYSIS COMPLETED BY THE EIGHT FOCUS CROUP MEMBERS VIA
       QUESTIONNAIRE.  THE QUESTION ABOUT FORMAT FLOW WAS MISUNDERSTOOD.

                                 "Chinese

 ! Format
 i Flow
             Yes
          Yes
  S*g^5psP^F:^^s^?rl^mvii*^!^lSf^
  ^^wsl^gf^eG^aa^atiaa.'^^^^^^^^l
                                                                  M*&'®fy$X$*8x^
                                                                       %gmi^
 ! 1. Clear, concise
Yes
Yes
                       Yes
No
Yes
Yes*     Yes
         Yes
  2. Translation
Exc.
2. Graphics
3. Effectiveness
Good
Exc.
Ave.
Good
Good
Exc.
Ave.
Ave.
Exc.
Exc.
Good
**
Good
Good
Good
Good
  4. Decision-making   Yes
             Yes
          Yes
No
Yes
Yes
Yes
Yes
         DNA=did not answer
         "Very good, but I suggested minor changes. Pis. see enclosed.
         ** Very good, again pis. see comments for minor changes.
                         Mdjl'ona' Comments by Focus Group Members
i  1.  I didn't care for the images of the child on a bike and the elderly man. They seem disjointed with the
i     pregnant figure. _ _^ _
I                           '          ~~~ - • -
I  2.  It is very informative. _
LJ: __ UleJ[gnslation is easy and simple to read. The words are concise and meant directly to the content.
I  4.  Please see attached. (Refers to editing on brochure.)  _
j  5.  (No comment)     _
                            brochure in English and Tagalog. Thank you. _________
| 7.  They are OK graphics and translation, except too many incorrect spellings.
 .8- ____ People will [ read_& L_understand easier after corrected. _
                                               157

-------

                                                                                                      ua=in 'red tide' c: Porolylic Shellah
                                                                                                      Poison (PSP).
                                                                                                      tide.'
                                                                                                      I-SOO-5S2-5&J7

                                                                                                                                      resin
                                                                                                               tturts-«r^:ur»i King County
                                                                                                      Health Deportment at.
                                                                                                      JOWJ6-021
                     Strict C«in- «rf A, £/,m
f J tr W5 Eaivonirjxnil P nxtcium Aimy CoriwnfljytAwriny Ptrumbip Craiu •EQS2XOJ-01-0

-------
                                                                                                                                                                        Q
o-
                              /ffltl-
                           5^*102:930113300
                                 euo'/i \d8
              sun'.3&juniU Refugee Federation
              Ser.ice Cenie* (RFSC).
             ' 2C6-715-9ISI
              '.'.'iidenie-.3-liT«f Cily leadership
              Developmenl |WiLD| Project at
              inleioalional Distnsl Housing Aliance
              IIDHAJ.
              2G&-6JI-5I3:
              reop/e forPugel So.;od 206-JS2-7007
                       iy :oi-296-4784
                         ounly -::5-839-5:30
                 hiiigion Sia.'e Depi. of Heaiili
              Coiisumec AssislciKe Haline
               I-S&8-56S-9427
              Reel fide iiVoimolioii Line
              U.S. Enviroi-imenlol ProlecKon Agency
              I-SS8-424-4372
              pwionmental Risk Infoimolcn Sen/ice.
              Uiiiversily Ol .
              206-6 1 6-75 57
ttn!' miu 8tidiiJiJ8incihjoijrc
         fiioariohu?
                                       8no aumaSutcSu (Ihejetugee Federation Servicie Cenler)
                                       S-inij tntim i^anunLBOLnuueihuari^aij (Ihe Universify of Washington's Deparlmenl
                                                      TA  *
                                       ol EnwonmenlorHeall
                                                                                                                75
                                             ~
                                        uanrflu. qenSat) ua: you 9 Biininn (PSP).
                                        /y/* (Parotylic SneBfah Poaon) (uaiin na«0a
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                                        i«rwcfle7»in reufig. irofi K-UJ a-mSSn cihi '
                                        oofiuS Di/iufrj. f.. fkU! 9 (bSii. fiicOuisa. «i-»ij

                                                                                                                         ON
                                                                                    antrvcflu. in. BU. u
                                                                                                                    thftei

                                                                                                     asaaj.
                                                                                   trneo. fife, na: 0^0 (FC8SJ.

-------

      ccaianu'i
      ua'-w "red lido" or Paratylk: ShclllJ^l
      Poison (PSP).
      tide.'
      1-800-542-5*32
                                      resin
               auns-vs^ajran King County
      Health Deparlmeni ol:
       206-296-4121 ,
fr«T tn-Rrfugn fidmnon StnictCmrr 
-------
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                                                                                              Couity Health Dcpirnncnt  (King County
                                                                                              Hung-Jaa Zaah Dimv Baengc Nya Docngi)
                                                                                              (206) 2JW-4722

                                                                                                      Loofc oaarr diuc ri tU nmr.
                                                                                              • Puk guoogc ga-dyuoz^ mteogi mbouz ayei
                                                                                              mngh jfi-aiiih acngc oya ga-naarr.
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-------
 rr-  /        ,   .                                   APPENDIX N5
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-------
OJ
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         •US EorironaimaJ IVnection Age
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-------
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          For More

  Information
      About Seafood:

       Community
         Contacts

•Refugee Federation Service Center
 Bilingual services available.
     206-725-9181
•Wilderness-Inner City Leadership
 Development (WILD) Project at
 International District  Housing
 Alliance (IDHA).
     206-623-5132
• People for Puget Sound
     206-382-7007
•Community Coalition for
 Environmental Justice
     206-720-0885

      Public Health
         Contacts

• County Health Departments
 •Seattle/KJneCo.    206-296-4784
 •SnohomislTCo.     425-839-5250
•Washington State Dept. of Health
 Consumer Assistance Hotline
     1-888-586-9427
•Red Tide Information Line
     1-800-562-5632
•U.S. Environmental Protection
 Agency
     1-800-424-4372
•Environmental Risk Information
 Service, University of Washington
     206-616-7557
A Friendly Health Message
   About Eating Seafood
           From the
        •Puget Sound-
    Is  Good
   for   You!
  But did you know that it
can sometimes harm you7
 TM an effort to understand the unique risks faced by the Asian Pacific American
 JL11 community, a study was conducted by the Refugee Federation Service Center
 and the University of Washington's Department of Environmental Health. For more
 information about the study, contact the Refugee Federation Service Center or the
 University of Washington (see For More Information).
                                                  Risks From
                                             Eating Bad Seafood

                                        Biological contaminants can cause many
                                        illnesses: hepatitis, diarrhea and PSP.
                                        PSP (Paralytic Shellfish Poison) or "Red
                                        Tide" is a poison. You may have
                                        tingling or numbness in your lips,
                                        tongue, neck, fingers or toes if you have
                                        PSP poisoning. In worse cases, you may
                                        have breathing problems and trouble
                                        moving your body.
Call for medical
attention immediately if
you experience these
problems.
This problem can be life threatening.

Eating too much seafood contaminated
with chemicals can lead to the build-up
of chemicals in your body. This may
increase your risk of:
 •Cancer
 • Kidney Damage
 • Brain Damage, and the
 •Ability to have healthy children.
                                              Contaminants

                                       Contaminants are things which can
                                       get into food and make you sick
                                       There are 2 kinds of contaminants:
                                           biological
                                                                                        and chemical
                                                                                        contaminants.
Biological contaminants are bacteria,
parasites, viruses, and fish poisons.
Fish poisons are caused by the food
the seafood eat.

Industries, farms,  and sewers all
contribute to the pollution that affects
your seafood.  Seafood that live close
to these sources of pollution are often
the most affected.

Examples of chemical contaminants
include mercury, lead, and PCBs.

                                                                                                        -
                                                                                                        -

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      Who is affected by
    eating contaminated
            seafood?


  Everybody!!!!

  But some people are
  more sensitive and
  should be more careful
  about eating potentially
  contaminated
  seafood, such
  •Pregnant women and
   their unborn children
                        Here's How to  Protect  Yourself
              Children of any age
  •The elderly and
 •People with medical problems,
  especially liver disease, diabetes,
  and problems with the immune
  svstem
 1
Know what types of seafood
are more likely to cause
problems:
 •Older and larger fish have more
  chance to store up toxins than younger,
  smaller fish.

 •Fish and shellfish that live at the
  bottom of the water tend to have more
  contaminants.

 • Some parts of the seafood may have
  higher amounts of contaminants, for
  instance, the "butter" of crabs is higher
  in toxins than the meat

 •Some species have special risks.  For
  example, poison from germs on
  spoiling tuna may cause allergic
  reactions.
2
                                            Know where your seafood
                                           came from:
 • Use safe fishing practices. Contact the
  Washington State Department of
  Health for safety information:
          1-888-586-9427

 •Pay attention to warning signs at the
 beaches and piers.

 • Check with the Washington State
 Department of Health for safe and
 open shellfish harvesting locations.
3
Use safe preparation practices:
                                   •Check to see if your fish is spoiling
                                    before you eat it. A strong fishy smell,
                                    softening of the meat, and hazy eyes
                                    on fish can be signs of bad fish.

                                   •Keep raw fish away from other foods
                                    being prepared.

                                   •Proper refrigeration after catching, and
                                    cooking all fish and shellfish before
                                    eating will kill most of the germs that
                                    can make you sick, but not all of them.

                                   •Cooking does not get rid of "red tide"
                                    [Paralytic Shellfish Poison (PSP)].
                                    You cannot tell if the seafood has PSP
                                    from the color of the water.
                                 For an updated recorded message of
                                 beaches closed due to PSP or "red tide,
                                 call the PSP Hotline at:
                                            1-800-562-5632

                                 For a list of beaches closed for health
                                 reasons, call the King County Health
                                 Department at:
                                            206-296-4722
Safe Cooking Ideas:
                                                                                                                       ' Remove the guts of the fish.
                                                                                                                        Chemicals build-up in them.
                                                                          • Remove the skin of the fish or
                                                                           poke holes in the skin. This lets
                                                                           the fat drain out and
                                                                           reduces the chemicals
                                                                           in the fish.
                                        •After cooking,
                                         throw out the
                                         remaining fat
                                         and juice from
                                         the fish (the fats
                                         and juices may
                                         have chemical
                                        contamination).
                                                                                                                                                       _
                                                                                                                                                       -
f untied tn L 'S Environmental Protection Agency Community I University Partnership Grant »EQ825003-01-0
                                                            tgenfiics and Environmental Health

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