| Summary: | Dioxins have been an inconvenience to the Baltic Sea ecosystem for decades. Although the concentrations in the environment and biota have continuously decreased, dioxins still pose a risk to human health. The risk and its formation vary in different parts of the Baltic Sea, due to variability in the environmental and societal factors affecting it. This paper presents a systematic literature review and knowledge synthesis about the regional dioxin risk formation in four sub-areas of the Baltic Sea and evaluates, whether systemic approach changes our thinking about the risk and its effective management. We studied the dioxin flux from atmospheric deposition to the Baltic Sea food webs, accumulation to two commercially and culturally important fish species, Baltic herring (Clupea harengus membras) and Baltic salmon (Salmo salar), and further to risk group members of four Baltic countries. Based on 46 studies, we identified 20 quantifiable variables and indexed them for commensurable regional comparison. Spatial differences in dioxin pollution, environmental conditions, food web dynamics, and the following dioxin concentrations in herring and salmon, together with fishing and fish consumption, affect how the final health risk builds up. In the southern Baltic Sea, atmospheric pollution levels are relatively high and environmental processes to decrease bioavailability of dioxins unfavorable, but the growth is fast, which curb the bioaccumu-lation of dioxins in the biota. In the North, long-range atmospheric pollution is minor compared to South, but the local pollution and slower growth leads to higher bioaccumulation rates. However, based on our results, the most remarkable differences in the dioxin risk formation between the areas arise from the social sphere: the emissions, origin of national catches, and cultural differences in fish consumption. The article suggests that acknowledging spatial characteristics of socio-ecological systems that generate environmental risks may aid to direct local focus in risk ...
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