Author(s): Kelly Madden

Reviewer(s): Dr. Carey Jackson

Date Authored: November 1, 2016

image of a pile of freshly caught fish
Photo by Maarit Lundbäck (cc license).

Note: The following is a general overview of the unique risks and health implications for refugee/immigrant communities near the Duwamish River. It is not intended to be comprehensive. A more complete article is in development to include information on sources of common pollutants, what communities are at higher risk, and typical clinical presentations.

Fishing has an immense cultural significance for communities in the Pacific Northwest. Many refugee/immigrant communities live off of subsistence fishing while native tribes rely on fishing for its cultural history, food supply, and income. Refugee/immigrant groups such as Hispanic, Somali, East Asian, Chinese, and Indian communities make up a substantial portion of those living by the Duwamish River (Balk 2015. However, the increased toxicity of water sources poises serious health risks (Manning 2015). The Duwamish River, for example, is Washington’s section of the Green River that offers local communities access to salmon, clams, squid, crabs, rockfish, flounder, and perch (Washington State Department of Health 2016). Many immigrant populations use this river as their main food source (Balk 2015).

chloracne herbicide worker ear

However, the river, as well as surrounding land, has been subject to industrial dumping for years (Seal Sitters 2016). Toxins such as polychlorinated biphenyls (PCBs), chlorinated dioxins, arsenic, lead, mercury, and pesticides are present in the water and are ingested by marine life (Washington State Department of Health 2016). When people ingest wildlife polluted with these substances, adverse health effects may occur. Ingestion of PCBs may cause dermal signs of chloracne, thyroid hormone toxicity, liver damage, decreased reproduction function, and decreased newborn neurobehavioral and behavioral functions (Agency for Toxic Substances & Disease Registry 2014). 

Along with the environmental factors, social factors increase the severity of this public health issue. Immigrant/refugee populations relying on subsistence fishing may continue consuming toxic fish due to a lack of resources (Smith 2011). Low socioeconomic status in some communities may mean people have limited funds to purchase food or pay for transportation to grocery stores (Rural Health Information Hub 2016). Medical care can be costly and not always accessible without transportation, leading some to delay seeking medical attention (Rural Health Information Hub 2016). Pertinent education about the toxic water may not be appropriately communicated to immigrant populations (Manning 2015). To individuals coming from other parts of the world, the Duwamish looks clean—there is no floating trash or murky color (Manning 2015). However, fishers new to the area are uneducated about the underlying risks (Manning 2015).

Environmental Community Resources

In Washington, individuals can also be exposed to toxins via air pollution, agricultural work, and other pesticide use. Unlike pollutants in waterways, toxins in the air and through pesticide exposure in food can be found in community locations such as schools, parks, and grocery stores in any region of Washington (Office of Sustainability & Environment 2016). 

A resource list of organizations devoted to the education and outreach for residents of Washington about these pressing pollutant issues is available in the sidebar.


Agency for Toxic Substances & Disease Registry. “Polychlorinated Biphenyls (PCBs) Toxicity What Are Adverse Health Effects of PCB Exposure?” Environmental Health and Medicine Education. Centers for Disease Control and Prevention, 30 May 2014. Web. 25 July 2016.

Balk, Gene. “A Spike in King County Foreign-born Populations.” The Seattle Times. The Seattle Times, 05 Oct. 2015. Web. 29 Aug. 2016.

Manning, Darwin. “Duwamish River Cleanup Plans Get a Boost for Inclusion.” The Seattle Globalist. N.p., 5 May 2015. Web. 25 July 2016.

Office of Sustainability & Environment. “Pesticide Reduction.” Pesticide Reduction., n.d. Web. 16 Aug. 2016.

Smith, Carol. “Unsafe to Consume: Despite Warnings, People Fish the Duwamish.” InvestigateWest. InvestigateWest, 20 Mar. 2011. Web. 26 July 2016.

Social Determinants of Health for Rural People.” Rural Health Information Hub. Rural Health Information Hub, 29 July 2016. Web. 29 Aug. 2016.

Toxic Waters Contaminate Marine Life.” Toxic Waters Contaminate Marine Life. Seal Sitters, n.d. Web. 26 July 2016.

University of Washington. “New Report Released on Health Impacts of Duwamish River Cleanup.” UW Today. University of Washington, 13 May 2013. Web. 29 Aug. 2016.

Washington State Department of Health. “Fish Consumption Advisories.” Community and Environment. Washington State Department of Health, n.d. Web. 26 July 2016. <>.