By Jingyi (Beatrix) Liu and Scout Yokley
During the 2025-2026 academic year, Masters of Environmental Management (MEM) students Beatrix Liu and Scout Yokley completed their Master’s Project with the Community Engagement Core (CEC) at the Duke University Superfund Research Center (DUSRC). Liu and Yokley explored a question rooted in nearly a decade of community concern in North Carolina’s Lower Cape Fear Region (LCFR): what happens when the fish that sustain a community also carry harmful contaminants?
The story behind this project began years earlier. Since 2016, a coalition of community organizations, researchers, and public health advocates has been working with residents in the LCFR who regularly fish from local rivers and creeks to supplement their diets. Many community members are aware that contamination exists in the river, but fishing remains an important source of affordable food, cultural connection, and recreation. Over time, increasing evidence of contamination in wild-caught fish—including mercury, PCBs, and more recently PFAS, or “forever chemicals”—raised urgent questions about how to effectively communicate health risks without ignoring the realities of food insecurity. The figure below documents fish tissue testing conducted by multiple entities between 1990 and 2025 and how this testing shaped fish advisories for the public.
Fish tissue sampling for metals, PCBs, and PFAS in the Lower Cape Fear River Basin, 1990-2025
PFAS, as indicated in the figure above, became a focus of this work in recent years. Nearly a decade ago, Wilmington residents learned that GenX, a PFAS compound discharged upstream from the Chemours Fayetteville Works facility, had been detected in local drinking water. Since then, researchers have continued detecting PFAS throughout the Cape Fear watershed in water and wildlife. In 2023, the North Carolina Department of Health and Human Services (NCDHHS) issued significantly stricter fish consumption advisories for the Middle and Lower Cape Fear River due to contamination from one type of PFAS (PFOS), recommending that some vulnerable populations avoid eating certain fish species entirely. Other advisories, for mercury, arsenic and chromium-6 (hexavalent chromium), continued to be in place for the LCFR.
Map of fish consumption advisories based on PFOS in Wilmington area
Map of fish consumption advisories based on Hg, As, and Cr(VI) in Wilmington area
These changing and overlapping advisories created a new challenge for the Duke Superfund Research Center’s long-running “Stop, Check, Enjoy!” campaign, a community-centered outreach initiative designed to help subsistence fish consumers better understand contamination risks and safer consumption practices. The project team recognized that updated scientific findings alone would not solve the problem. Risk communication also had to account for why people fish in the first place and what alternatives realistically exist.
Through discussions with DUSRC staff and community partners including Cape Fear River Watch, NC Coastal Federation, and the Center for Human Health and the Environment at NCSU, the project narrowed its focus to three overarching questions:
1. What are the primary sources of contaminants in fish from the Lower Cape Fear River and the associated health impacts of consuming them?
2. What strategies can support subsistence fish consumers in reducing their reliance on wild-caught fish?
3. What communication approaches can effectively convey risk while promoting safer and more accessible alternatives?
To answer these questions, the team conducted an extensive scientific literature review examining contamination pathways, PFAS accumulation in fish, health impacts associated with exposure, and existing fish consumption advisories. The research showed that PFAS contamination is widespread throughout the watershed and that fish contamination varies by species, location, and trophic level. Predatory species often accumulate higher concentrations of PFAS through bioaccumulation and biomagnification processes. The literature also highlighted growing concern about cumulative impacts from exposure to multiple contaminants simultaneously, an issue current advisories do not address.
But scientific literature alone could not fully explain how contamination affects the community. To better understand food insecurity and barriers to alternative protein access, Liu and Yokley conducted semi-structured interviews with food bank leaders, nutrition educators, faith-based organizations, and others working directly with food-insecure populations in the region. Using qualitative coding methods, Beatrix and Scout identified recurring themes related to economic instability, transportation barriers, limited access to nutritious foods, and the importance of trusted community relationships in effective outreach efforts.
The interviews reinforced a key finding: subsistence fishing in the Lower Cape Fear River cannot be understood simply as an individual choice. For many residents, fishing exists at the intersection of food insecurity, culture, accessibility, and environmental inequality. Community partners also emphasized that messaging focused only on danger or restriction is unlikely to succeed without simultaneously offering realistic alternatives and support.
Based on these findings, the project developed six recommendations to strengthen and update the “Stop, Check, Enjoy!” campaign:
- Distribute educational materials through food banks and food assistance networks
- Continue collaborating closely with trusted community organizations and leaders
- Pair contamination messaging with accessible alternative protein options
- Develop “Eat and Learn” style educational programming, especially for women and families
- Better understand how wild-caught fish move through communities and shared networks
- Improve communication around the health impacts of PFAS and cumulative contaminant exposure
Ultimately, this project highlights that environmental health communication must go beyond simply sharing scientific facts. Effective community engagement requires understanding the broader social conditions shaping people’s choices, listening to lived experiences, and working collaboratively toward practical solutions.
This work would not have been possible without the immense support, guidance, and dedication of the Duke Superfund Research Center Community Engagement Core and its coalition of community partners, including Cape Fear River Watch, NC Coastal Federation, and the Center for Human Health and the Environment at NCSU. Their years of advocacy and relationship-building continue to drive this work forward.