An Outdoor Enthusiast Finds a Career in Environmental Health

Apr 23 2014 :: Published in Environmental Health

April 20-26 is Laboratory Professionals Week! This year APHL is focusing on environmental health and the laboratorians who work to detect the presence of contaminants in both people and in the environment.  This post is part of a series.

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By Henry Leibovitz, Ph.D., Chief, Environmental Sciences, RI State Health Laboratories

Growing up along the south shore of Long Island’s eastern end, my interests covered everything aquatic.  My every waking hour was spent on the water fishing, boating, clam digging, and exploring. My every dream was driven by the excitement of the sea. It was an exceptional lifestyle for an adolescent who cared more about adventure than academics. Nonetheless, my future was destined to involve higher education and research by the vision of my father who was a veterinarian, a research scientist and veterinary college professor.

An Outdoor Enthusiast Finds a Career in Environmental Health | www.aphlblog.org

While earning my BS in Biology, a close priority became serving as president of the outing club, an adventure wilderness group of students spending weekends in the Adirondack Mountains. Opportunity also came to me in campus residence life as I worked as a resident advisor and then assistant dormitory director. The training and experiences included interpersonal communication, conflict resolution, supervision and management as well as life lessons that would play a major role later in my laboratory career. Upon graduation, my passion had become feeding the world through aquaculture.

After marrying my college sweetheart I enrolled in an MS degree program of Fisheries and Allied Aquaculture at Auburn University. Waking up before dawn to measure dissolved oxygen levels in the catfish ponds and constantly worrying about the threat of O2 depletion, and losing thousands of pounds of fish was not going to be my way of life. The laboratory environment became much more interesting. My major professor introduced me to the nutritional biochemistry of fish diets and feeds. Replacing fish meal with soybean meal in catfish diets was the subject of my research and thesis. “We are what we eat!” With fish I learned that feed analysis is critical to understanding how diet affected the growth, health and production of farmed fish. I earned my MS realizing that laboratory scientists have a significant role in feeding the world just as the farmers do.

I landed a research associate position on a project at Louisiana State University funded by a NIH grant to develop laboratory grade bullfrogs (Rana catesbiana) in place of the wild caught overly-stressed specimens for neurophysiologic research. My role was to improve the diets for larval stages of tadpoles!  In the laboratory we bred and raised several bullfrog line generations. During metamorphosis however tadpoles frequently developed skeletal deformities including scoliosis. My research focused on dietary and environmental factors that were causally suspected. While the research was very interesting, I became convinced that it would be more rewarding to lead the research activities and that earning a Ph.D. was necessary to continue my career.

During my Ph.D. program at the University of Rhode Island I worked as a research associate for the Department of Food Science and Nutrition. My duties as instrumentation specialist involved me in a variety of the department’s research activities. While pursuing my doctoral dissertation developing microencapsulated diets for larval marine fish, I learned the importance of elucidating environmental components such as pesticides, PCBs and metals in natural (plankton and brine shrimp) and formulated diets (various fish meals, fish oils, grains and other ingredients) for growth and survival during fragile larval stages.

Learning to apply the tools of analytical chemistry to the analysis of environmental components in feed and living organisms, I forged my career path into environmental laboratory analysis.  After earning a Ph.D., I worked for an environmental analysis laboratory starting as supervisor and eventually as laboratory director before the company moved to South America. We provided laboratory services to national clients including the US Department of Defense, EPA and many environmental engineering contractors. We analyzed sample matrices included air, water, soil, biota and food. Professionally I was so rewarded by the teaching, research and managerial aspects of my job that I didn’t expect to find in the commercial sector. Teaching newly hired graduates, improving methodology and instrument performance, and sharing a vision of the critical paths to achieving objectives kept me interested in the work. Client centric laboratory services were important to me.

In 2004 I was hired by the RI State Health Laboratories (SHL) as Quality Assurance Officer in the Environmental Laboratory Sciences section. In 2007 I became Chief Environmental Laboratory Scientist of the section that includes the chemical and microbiological analysis of drinking water, food, air, dairy, shell fish, recreational water and ambient river samples for the health and environmental program partners we serve. I point to the dedication of staff, peers and colleagues for the successful SHL services provided to our state health and environmental program and industrial partners.

As a public servant I have come to understand that the existence of our laboratories depends on the successful outcomes of our partners in public health and environmental protection.

Outside of work I enjoy spending time with my family and I still pursue the adventure of the great outdoors all seasons of the year.

 

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My Earth Day — My Community

Apr 22 2014 :: Published in Environmental Health

April 20-26 is Laboratory Professionals Week! This year APHL is focusing on environmental health and the laboratorians who work to detect the presence of contaminants in both people and in the environment.  This post is part of a series.

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By Surili Sutaria Patel, Senior Specialist, Environmental HealthAPHL 

My Earth Day -- My Community | www.aphlblog.org
Today is Earth Day!  People all over the world plant trees, clean up their communities, contact their elected officials to take action and more. By protecting the environment, we are protecting our health from harmful pollution and hazardous contaminants found in our environments.

Yet not all environments are created equally. Some communities throughout the US are faced with environmental health issues because of where they are or their residents’ socio-economic status. Such communities are often disproportionately exposed to harmful pollutants. Achieving environmental justice – or the fair treatment and meaningful involvement of all people (regardless of race, color, national origin, or income) with respect to the development, implementation, and enforcement of environmental laws, regulations and policies – is key to truly protecting the health and environments of all.

In an effort to better link concerned communities with their public health laboratory to answer questions about environmental contaminants, APHL is proud to launch the Meeting Community Needs through Environmental Laboratories web-based tool. Created for advocacy and consumer groups to better understand the role of an environmental public health laboratory, this resource aims to address how the public health system can better utilize the rich capabilities of laboratories to meet environmental health needs. The site contains the APHL report on Meeting Community Health Needs through Environmental Health Labs, presentations from a forum held in 2012, a YouTube video, next steps and more. The site also hosts a discussion board where anyone can post questions about environmental health concerns.

Read a recent blog post by our partner, Dr. Jalonne L. White-Newsome at WE ACT for Environmental Justice, entitled, “What are Environmental Justice Communities and how can Laboratory Testing Protect the Most Vulnerable?

Join the discussion today and tell us about your community environmental health concerns!

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What are Environmental Justice Communities and how can Laboratory Testing Protect the Most Vulnerable?

Apr 22 2014 :: Published in Environmental Health

April 20-26 is Laboratory Professionals Week! This year APHL is focusing on environmental health and the laboratorians who work to detect the presence of contaminants in both people and in the environment.  This post is part of a series.

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By Dr. Jalonne L. White-Newsome, Federal Policy Analyst, WE ACT for Environmental Justice

Choices. One of the most difficult choices my 4-year old had to make before starting school was which bookbag she wanted. It was a close call between the shiny Dora bookbag with the pink and purple zippers or one of her favorite Disney princesses. As a mom, however, there are slightly more difficult choices I have to make.

What are Environmental Justice Communities and how can Laboratory Testing Protect the Most Vulnerable? | www.aphlblog.org

My choices are based on keeping my children safe, happy and healthy. So when I found out that many of the products I typically purchased for my daughter – like the Dora bookbag – were made from chemicals like phthalates and bisphenol-A (BPA), I grew concerned. The chemicals found in these products commonly sold in variety stores, or price-point retailers that sell inexpensive items with a single price for all or most of the items in the store, are linked to adverse reproductive and neurodevelopment health outcomes, as well as higher predisposition to diabetes and asthma. While avoiding EVERY hazardous product is unrealistic, having the choice – as well as the resources and knowledge to make informed choices – is key. But not everyone has that choice or access to this knowledge.

Environmental justice (EJ) communities are usually described as communities of color and/or low income communities that are disproportionately burdened with environmental pollution. Members of EJ communities are often the same people exposed to potentially unhealthy products. Residents’ choices are limited to products sold at these retail establishments, such as local variety store or bodegas, due to financial and transportation barriers. At the same time, members of EJ communities are often unaware of the health consequences of their product choices.

As a Federal Policy Analyst for WE ACT for Environmental Justice, I have the opportunity to work on multiple environmental issues that disproportionately impact communities of color and/or low income communities. While the specific issue of toxic exposures from consumer goods has typically been omitted from the traditional definition of EJ, it is now more important than ever that we make these connections, especially in a world where cumulative impacts and risks are becoming an integral part of analyzing risk.

So the question becomes: are communities of color, and/or low income communities more exposed to hazardous consumer goods than communities with a different socio-demographic profile? To begin answering this question, WE ACT’s environmental health team engaged in a community-academic partnership to quantify the proliferation of toxic chemicals in northern Manhattan, NY. WE ACT created a database of businesses that sell products that typically contain hazardous ingredients – such as skin-lightening cream and hair relaxers – that target EJ communities.

This is not a concern limited to the northern Manhattan communities, but communities across the US. Many national coalitions are forming across the country to raise awareness about consumer products that contain potentially-toxic chemicals. Additional concerns surround chemicals used in certain industries – like hair and nail salons – where minorities are exposed to toxic fumes daily without proper ventilation. Although we can speculate that some communities are disproportionately exposed to harmful chemicals, the ability to quantify the exposures to research on the potential health impacts remains critical.

While efforts by the U.S. Environmental Protection Agency (EPA) and other non-governmental organizations aim to protect EJ communities from environmental hazards, limited research compares the health impacts of consumer goods and the exposure profile of communities that face EJ issues to other communities.  It is very important that researchers answer some of these concerns with hard data. By testing common products for potentially-toxic chemicals, especially products sold in variety stores, we can inform community members and advocate for better choices.

The Toxic Substances Control Act (TSCA), enacted in 1976, is one of the laws that serve as the primary source of protection for human health related to consumer products. Revisions to TSCA are currently underway in Congress, with many members of the EJ community and national coalitions fighting to ensure that the revisions reflect their concerns and codify the solutions needed to address the particular sensitivity of EJ communities such as cumulative risk. Comprehensive chemical policies at the federal level combined with consumer products testing can change the landscape of the market. APHL aims to promote good laboratory practice and data quality for consumer product testing. To join APHL in a discussion on environmental justice and consumer product testing, please visit the Meeting Community Environmental Health Needs webpage. This site aims to help you navigate the system, while ultimately improving the governmental environmental health system, while ultimately improving that very same system for other concerned communities.

To learn more about Achieving Environmental Justice through public health laboratory practice, visit the Fall 2012 issue of APHL’s Lab Matters magazine.

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Scientist? Actress? Or President?

April 20-26 is Laboratory Professionals Week! This year APHL is focusing on environmental health and the laboratorians who work to detect the presence of contaminants in both people and in the environment.  This post is part of a series.

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By Laurie Peterson-Wright, Chemistry Program Manager, Colorado Department of Public Health and Environment

Who would have known that the 1973 fifth grade class of Beadle Elementary in Yankton, South Dakota could predict the future?  As a classroom exercise, we all had to vote on what we would each be when we grew up.  I received 10 votes to become an actress, 10 votes to become a scientist and even one vote to be the first woman president!

Scientist? Actress? Or President? | www.aphlblog.org

My parents were adamant that I finish every project, class, book, craft or book I started.  This instilled within me a commitment to never quit and a sense of wonderment at where the next bit of knowledge and hard work would take me. My passion for any type of science began at a young age.  I would stay glued to my microscope or my telescope at night.  I wanted to learn everything about how humans and the universe operated.  I had so many educational ambitions – teaching, mathematician, certified public accountant, physicist, medical doctor, astronaut (and let us not forget Hollywood Star) – but after many years in school, I reeled my focus in to chemistry, mathematics and business administration.

My first position was in cancer research, but I was shortly introduced to environmental chemistry and project management.   I was intrigued by how chemical and radiological pollutants interacted with the environment and what we could do to mitigate exposure, especially for sensitive populations.  I spent 15 years in the environmental remediation/waste management field and then accepted a position with the State of Colorado Chemistry Program in 2001.  Immediately I embraced public health and how these same contaminants in the environment could be so easily transported.  I was fascinated by how they interacted with the human body including sensitive human and animal endocrine systems.

This world is an amazing place! By continuing to focus on my passion in public health, I will only increase my knowledge of how all sensitive systems are interconnected.  Live gently, and also boldly, my fellow scientists.

Oh, and by the way….I still act…and PS don’t tell my parents I never finished Moby Dick.

 

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Measuring Household Dust for Potentially Dangerous Chemicals

Apr 08 2014 :: Published in Environmental Health

This blog post is part of a biomonitoring series.

Can analyzing our household or workplace dust help scientists predict the levels of potentially dangerous chemicals inside our bodies?

In a world where furniture, carpets, curtains and electronics are treated with potent flame-retardant chemicals, we are exposed continuously to novel chemical substances upon which little research has been conducted. The use of flame retardants has become necessary due to changing types of materials used in our household goods.

Measuring Household Dust for Potentially Dangerous Chemicals | www.aphlblog.org

“Think of your living room and all the synthetic materials used in the furnishings and curtains,” said Myrto Petreas, PhD, MPH, from the California Department of Toxic Substances Control. “Now compare that to what was in your grandmother’s living room. Her furniture was probably made with horsehair and wool, and was inherently not prone to fire. With synthetic fabric, there is more fire danger.”

The concern about flame retardants, she said, is that very little is known about these chemicals or what levels, if any, are safe for humans.

Around the time polychlorinated biphenyls, more commonly known as PCBs, were banned in 1979 due to human carcinogenic effects, chemists began creating new flame-retardant chemicals. Fifteen years ago, Petreas and her staff encountered one of the newer ones for the first time. “We were measuring chemicals in a study of breast cancer and looking at the body fat, levels of PCBs, etc. I went to a meeting in Sweden in 1998, where a researcher presented on these new chemicals, PBDEs (polybrominated diphenyl ethers), found in high levels in human breast milk. Back at the lab, I wondered, ‘Can we see it here?’ The levels were so high, I thought it was a mistake.”

Pausing, Petreas added, “The levels are 30 times higher in California now than they were in Sweden then.”

While researchers do not know for sure that the brominated flame retardants, especially the PBDEs, are carcinogens, they are structurally similar to the banned PCBs. They also assimilate into our fat. PCBs, although banned 35 years ago, are still found commonly in people, said Petreas, “because they are in the food web now.” Banning a chemical cannot eradicate it from the population, she explained, but “PBDEs are placed on purpose in our products. We are exposed through dust more than diet. After they are banned, 20 years from now, those PBDEs will be in the food web too, in birds and cows. They stay a long time in the body.”

PBDEs are endocrine disruptors that compete with the thyroid’s hormones, potentially affecting development and cognitive abilities. “In animals,” said Petreas, “they are carcinogens; in humans, we can now look and see but do not have the answers yet.”

The question about whether chemical levels found in dust can help predict the levels in our bodies is an interesting one to biomonitoring scientists who study chemical levels in the human body. “What you see in the dust takes many steps to reach your body,” said Petreas. Just because the chemical is in the air or dust does not mean that your body will absorb it. Also, it is possible that chemicals may be dangerous in combinations rather than alone. Genetics also likely influence susceptibility. Biomonitoring is a sufficiently new science that many questions remain unanswered.

However, it is feasible that scientists could get a good idea of exposure merely by studying the contents of a household’s vacuum cleaner.

Petreas’ lab has worked on two dust studies. One, the California Childhood Leukemia Study, with UC Berkeley, is looking for correlations between childhood leukemia and chemical exposures found in the home. The study is not complete but after looking at the dust samples, Petreas said, “we have seen differences among homes and geography. There is a socio-economic factor: there are higher levels of PBDEs in house dust among lower income households and people of color.”

They also found a high correlation in results from dust tests repeated 3-8 years apart on the same home, showing that the chemical levels were not declining much over time.

The second study, the Firehouse Dust Study that compared levels of pollutants in the blood of firefighters and in the dust of the firehouses, was a side-study of the Firefighters’ Occupational Exposures (FOX) study, conducted by Biomonitoring California with UC Irvine.

“In this pilot study, we tested the blood and urine of 99 men and 2 women,” said Petreas. “We had questionnaires about their work: do they work with forest fires or structural fires? What kind of protective gear do they have and is it used? Later, we wanted to combine the environmental measure with this earlier biological measure. We took samples of dust from the station’s vacuum cleaners. This gives an overall integrated measurement to what the firefighters have been exposed to over time in the firehouse.”

They discovered, perhaps unsurprisingly, that firefighters did have much higher levels of flame retardants in their blood than an average person. Researchers are still trying to identify the main sources of exposure.

Actually, PBDE levels in Californians are higher than in most Americans, largely because of the state’s unique flammability requirements. Petreas pointed out that because the California market is so large, many corporations are designing products to meet the state’s stringent flammability standards and then selling them across North America. As a result, PBDE levels in North Americans are much higher than in Europeans or Asians.

“[Researchers] are always a few levels behind the marketplace,” said Petreas. “We measure the PBDEs now, but already there are different chemicals being used and we don’t know what they are. We can see these chemicals in our samples, but we haven’t studied them yet.”

An important factor in launching these studies has been the creation of Biomonitoring California, a legislatively mandated program that aims to determine baseline levels of environmental contaminants in Californians, study chemical trends over time, and advise regulatory programs. Biomonitoring California is a collaborative effort between the California Department of Public Health, the Office of Environmental Health Hazard Assessment, and the Department of Toxic Substances Control.

“What else is out there that we don’t know about and haven’t looked for?” Petreas asked, echoing a concern that led to the creation of Biomonitoring California.

To reduce exposure to potentially dangerous chemicals, whether from dust or other sources, Petreas said, “Wash your hands before you eat. Just like your mother told you. Never eat at your computer. Leave your shoes outside. These things help with most public health concerns, whether avian flu or chemicals.”

_____________________

Without biomonitoring, public health practitioners face challenges in understanding whether environmental contaminants are actually being absorbed into people’s bodies. Given improvements in technology, the capabilities and expertise that exist in public health laboratories, and the increasing demand from the public for more information about chemical exposures, biomonitoring is poised to become an integral component of public health practice.

To learn more about biomonitoring, check out some of APHL’s Biomonitoring Resources:

Stay tuned for our soon-to-be-unveiled Meeting Community Needs page and of course, let us know if you have any feedback or suggestions.  

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Returning Biomonitoring Test Results in an Easy-to-Understand Format

Mar 11 2014 :: Published in Environmental Health

This blog post is part of a biomonitoring series.

Returning Biomonitoring Test Results in an Easy-to-Understand Format | www.aphblog.org

California passed novel legislation in 2006 that united three state departments in a new program called Biomonitoring California. These three departments—the California Department of Public Health, the Department of Toxic Substances Control and the Office of Environmental Health Hazard Assessment—are tasked with learning more about the chemicals found commonly in Californians, studying chemical trends over time and helping assess the effectiveness of current environmental chemical regulations.

“To address this legislation, we work very closely with our partners,” said Sandy McNeel, DVM, from California’s Department of Public Health. “We have different areas of expertise, so it is a very useful collaboration.”

The legislation defines “community” broadly with respect to biomonitoring studies. “Communities are not only geographically based, but also could be a group of pregnant women or a group who, because of their occupation, may have unusual exposure to certain chemicals,” said McNeel. Since inception, the program has initiated community-based studies of various types and collaborated with other researchers within state government and academia.

As these pioneering biomonitoring studies proceed, the state’s researchers are wrangling with an interesting facet of the law: they are required to return individual test results to all study participants who request them—in an easy-to-understand format.

While it may sound simple, it is very challenging to translate medical and laboratory research into straightforward English; or Spanish, as the case may be.

Still, the greater challenge is that no one, not even the scientists, really knows what some of the biomonitoring results mean in relation to human health. Whether a chemical causes health problems depends on how toxic the chemical is, how much a person takes in, and how long a person is in contact with the chemical.

Biomonitoring is a relatively new branch of laboratory science and new chemicals enter the marketplace every day. There are tens of thousands of chemicals in use today, many of which have not been studied throughly. Discovering possible health effects of chemicals can take years of research. Even with evidence that a chemical causes a particular health effect, it is difficult to know what level in people’s bodies would be harmful. Someone may have a high level of a chemical in her body and never have any effect from it. Another may have a similar level of the chemical and become ill, perhaps due to her genetic predisposition, an underlying health problem, other exposures, or additional unknown factors.

To help make all of this information clear to study participants, Biomonitoring California assembled a team that includes data analysts, chemists, epidemiologists, toxicologists, and health educators to identify what information would be useful to participants and how it should be worded or displayed for best effect.

After working through many versions of the results return format, the team field-tested it for feedback. The team simulated a set of biomonitoring test results and asked groups of volunteers from two ongoing studies to help refine it.

In one of those studies, the Firefighter Occupational Exposures (FOX) project, firefighters had been tested for a large number of chemicals, including some potentially dangerous flame retardants. The simulated results used in the testing process came with clarifying text, tables, graphs and a one-page fact sheet on each chemical or class of chemicals.

“We developed the materials to report results keeping in mind that the vast majority of study participants do not have a chemistry background or an understanding of what chemical exposure might mean,” said McNeel. “We spent quite a bit of time developing the text, thinking about the most understandable yet scientifically accurate way to describe the results.”

An individual can compare his or her results to others from the same study, as well as to data from the National Health and Nutrition Examination Survey (NHANES) when available.  This way a study participant can see where he or she stands in relation to a representative sample of the United States’ general population.

After the simulated results were shared with the firefighters, a couple of the biomonitoring staff met with them to identify any points of confusion. The feedback led the team to add an explanation of why this community, in particular, was being studied and why the human health implications of most chemical exposures are still largely unknown.

Going forward, as results are returned to study participants, Biomonitoring California staff will follow up to see if people have a good understanding of the test results.  “We tested, revised, tested, revised and still we consider these works-in-progress. We will continue to fine-tune the results return documents as we get more feedback from participants,” said McNeel.

McNeel added that, despite the results return team’s best efforts, some firefighters did express a degree of frustration about why they were being tested for chemicals if no one knows what the results mean. “Firefighters are an altruistic group of individuals,” she said. “We explained there just hasn’t been the research done to determine whether there are health effects associated with some of these chemicals and at what level health effects might start to occur. Some of our work is to help establish chemical levels in various groups so that we can compare and contrast them, and that this work will benefit future firefighters.”

Researchers with Biomonitoring California have found this design process rewarding. “All of us in the program really feel that it’s important for people to have a better understanding of chemicals in our environment,” said McNeel, “This is an area that deserves greater attention.”

To see an example of a results document, visit www.biomonitoring.ca.gov/sites/default/files/downloads/03162012FOXMockResultsPacket.pdf.

Without biomonitoring, public health practitioners face challenges in understanding whether environmental contaminants are actually being absorbed into people’s bodies. Given improvements in technology, the capabilities and expertise that exist in public health laboratories, and the increasing demand from the public for more information about chemical exposures, biomonitoring is poised to become an integral component of public health practice.

To learn more about biomonitoring, check out some of APHL’s Biomonitoring Resources:

Stay tuned for our soon-to-be-unveiled Meeting Community Needs page and of course, let us know if you have any feedback or suggestions.  

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Biomonitoring Project in Native American Community Helps Protect and Inform

Mar 05 2014 :: Published in Environmental Health

This blog post is part of a biomonitoring series.

Dr. Carin Huset began her career measuring chemicals in water, not people. “My doctoral thesis was on PFCs in wastewater, rivers and landfills,” she said. “It was all environmental, not public health, and much more abstract.”

Huset now spends her time testing people for chemical exposure. This work, known as biomonitoring, is on the leading edge of public health laboratory science. Huset and other laboratorians at the Minnesota Department of Health (MDH) public health laboratory are able to measure the amount of natural and manufactured chemicals inside of a person by analyzing blood or urine.

Currently, Huset and partners in the local health community are working with a group of Native American volunteers from the Fond du Lac Band of Lake Superior Chippewa to measure the chemical levels in their bodies. People living in this community may have greater contact with environmental chemicals as consumers of traditional foods such as fish and waterfowl.

Biomonitoring Project in Native American Community Helps Protect and Inform | www.aphlblog.org

This biomonitoring project is part of the wider federal Great Lakes Restoration Initiative (GLRI), which is focused on cleaning up toxins, resisting invasive species, protecting watersheds from polluted run-off and restoring wetlands. The GLRI is funding the MDH’s work with members of the Chippewa tribe to determine the impact of pollution on the local population.

Since biomonitoring is a relatively new area of laboratory science, Huset and her partners began designing a study that had no real counterpart, and therefore had to overcome a series of mundane, but critical, difficulties. Minnesota staff needed to work out tricky legal agreements with partner labs, add a new testing capability, identify and interview the study’s participants, and train clinic and other external staff.

“We needed to design a study that met the concerns of the community, as well as the requirements of the GLRI,” said Huset. The GLRI wants data on exposure to eight PCBs, Mirex, HCB, DDT and DDE, lead and mercury; the Minnesota laboratory added more than a dozen additional analytes to the test panel. Although mainly testing for chemicals resulting from potential environmental exposure, the lab chose to include a few extra, such as cholesterol and Hemoglobin A1C, which will allow study participants to follow up with their doctors to make personal health decisions. The lab is also studying the level of Omega-3 fatty acids in the participants, high levels of which are considered a positive effect of eating fish.

To conduct all of these tests, the clinic staff is “drawing 44 milliliters of blood, or about 7 tubes,” said Huset. Because each person’s blood must be divided for the varied laboratory tests and then delivered to more than one location, it was essential to design an easy-to-use sample kit; particularly since the blood is not drawn in-house, but at a clinic on the reservation. To reduce sample contamination and confusion, the kit has twenty different sample cups and vials with different colored caps.

A lab employee travels up to the clinic each Friday to collect the week’s frozen blood and urine samples, in part due to the clinic’s limited storage space, but more importantly, said Huset, because “the samples are precious and we worry about the potential for a power outage over the weekend, which would ruin them.”

Once the samples reach the MDH public health laboratory, some of them are then batched and sent to the Michigan Department of Community Health Laboratory or to private labs. Huset explained, “When the GLRI funding came through, one of the required tests was for PCBs, which affect other parts of the Great Lakes region, but are not a significant concern in Lake Superior or Minnesota.” Minnesota lab staff do not see a strong need for their facility to have this particular testing expertise, especially since PCB testing is relatively complex; also important, the GLRI funding did not come with an allowance to add new capacity. Fortunately, the Michigan laboratory has a robust PCB testing program.

“The contract work between the two states was more challenging than we expected. Both labs were willing participants, but we didn’t allow for the problems among the lawyers and the wording of the contracts,” said Huset. Once the technicalities were resolved, the partnership has worked smoothly.

Due to similar legal complications with a different laboratory partner, the Minnesota lab elected to allocate some of its own funds to develop testing capacity for 1-hydroxypyrene. “This was a test we wanted to develop anyway,” said Huset, “and it’s far less complicated than the PCB testing.” 1-Hydroxypyrene has been included in the study due to potential contamination in a Lake Superior watershed adjacent to a SuperFund site.

A great advantage to the researchers is that the Fond du Lac Band of Lake Superior Chippewa are “a very engaged and interested group,” said Huset. Participants have answered extensive questions about their personal history and habits.

A community’s engagement in a biomonitoring project is vital to its success. Prior to this GLRI project, the MDH ran four successful biomonitoring pilot studies, measuring arsenic levels in the urine of children who had played in contaminated soil, mercury in newborn screening collection cards, chemicals in pregnant women, and PFC levels in the blood of people affected by a contaminated community drinking water supply.

In the drinking water study, the participants’ commitment spurred the project on. “The community knew about their water contamination and were concerned. They pushed their legislators to push the funding through for the study,” said Huset.

In this case, PFC contamination had been discovered in 2004 in both private and municipal wells in a community. By the end of that year, the community’s exposure had been reduced through a combination of methods, including treating the municipal well, installing in-home filters, encouraging the consumption of bottled water, or transferring homes from private wells to the public water supply. In 2008, MDH conducted its initial biomonitoring study on people who had been exposed to the contaminated water and discovered that the levels of PFCs in their blood were higher than national levels. But then, in a follow up study in 2010, MDH discovered that the community’s average blood PFC levels had declined since 2008. The biomonitoring project demonstrated that the public health efforts undertaken in 2004 to reduce exposure had worked.

“This was a targeted public health action,” said Huset, “and it was effective.”

Part of the complexity of this process, in the pilot projects and again with the GLRI, is determining which chemicals to look for, what levels in people are safe, and when authorities should take action.

Noting the difference between measuring the chemicals levels in people and her earlier environmental work, Huset said, “People everywhere are very interested in what we do here, and they have a lot of questions.” Researchers do too, still trying to determine which pathways of exposure—such as diet, occupation or hobbies—predict contaminant concentrations in people. As studies like the GLRI project progress, it will be easier to identify public health actions that will protect people at increased risk of chemical exposure.

At the end of this study (sometime in 2014) researchers will have valuable new information about chemical exposure and human health. For more information about the Fond du Lac Band of Lake Superior Chippewa biomonitoring study, see www.health.state.mn.us/divs/eh/risk/studies/tribalstudy.html.

Without biomonitoring, public health practitioners face challenges in understanding whether environmental contaminants are actually being absorbed into people’s bodies. Given improvements in technology, the capabilities and expertise that exist in public health laboratories, and the increasing demand from the public for more information about chemical exposures, biomonitoring is poised to become an integral component of public health practice.

To learn more about biomonitoring, check out some of APHL’s Biomonitoring Resources:

Stay tuned for our soon-to-be-unveiled Meeting Community Needs page and of course, let us know if you have any feedback or suggestions.  

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West Virginia’s Spill and the Importance of Laboratories

Mar 04 2014 :: Published in Environmental Health

By Megan Weil Latshaw, Director, Environmental Health Programs

Living in the United States usually means we can expect clean water every time we turn on our tap.[1] But for over a week, hundreds of thousands of West Virginians were unable to use their water for drinking, bathing, showering or even brushing their teeth.[2]

The recent Elk River story led to many questions about chemicals policy in the US. For example, the New York Times called into question WV’s regulatory framework and National Public Radio discussed the lack of oversight of chemical storage facilities. It also drew attention to our lack of knowledge about these chemicals:

  • Deborah Blum, a Pulitzer-Prize winning writer, highlighted how little we know about chemicals in commerce.
  • The Director of the US Centers for Disease Control & Prevention (CDC) pointed out how little they knew about the original chemical of concern, 4-methylcyclohexanemethanol or MCHM.

West Virginia’s Spill and  the Importance of Laboratories | www.aphlblog.orgBut despite all the news around the spill, few articles mentioned the role of laboratories. The West Virginia Public Health Laboratory was one of the labs that stepped up to handle the surge in water samples. Environmental chemists worked around the clock and chemists from other parts of the laboratory were pulled in to help. They adapted a CDC method that allowed them to report results three times faster than the other responding laboratories. The end is not quite yet in sight: the lab continues testing tap water samples due to concerns about the lingering odor associated with the chemical.

Here at APHL we’re proud of the public health laboratories who have built capability & capacity to detect chemical contaminants, not only in water, but also in people. These public laboratories, whose sole mission is to protect the public’s health, are prepared to operate 24/7 in order to do so.

We’re also proud of the progress being made by federal agencies to build laboratory networks across the country, able to handle just such emergencies (such as EPA’s Water Laboratory Alliance and the Laboratory Response Network for Chemical Threats funded by CDC). There still remains a lot of work to be done though:

  • Barriers to activating these networks remain. We need additional funding to increase their visibility, broad usefulness & efficiency.
  • Neither of these networks provides funding to detect radiological agents.
  • Electronic exchange of data between laboratories, crucial during emergencies for prompt decision making, remains highly inefficient.
  • Due to funding cuts, laboratories struggle to maintain well-trained personnel and aging equipment.

 


[1] As NPR recently pointed out though, we only monitor public water supplies for ‘known’ contaminants. What about all those ‘unknowns’ like pharmaceuticals or personal care products that get washed down the drain or flushed? APHL called on EPA to work with states on additional drinking water contaminant monitoring systems.

[2] The Wall Street Journal published a timeline of the spill and response.

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Integrating Biomonitoring with CDC’s National Environmental Public Health Tracking Program

Feb 26 2014 :: Published in Environmental Health

This blog post is part of a biomonitoring series.

In 2011, CDC’s National Environmental Public Health Tracking Program formed a Biomonitoring Task Force, composed of grantees from the agency’s Tracking Network. Members of the new task force were asked to find out what biomonitoring data exists in states and, where possible, to add it to the national tracking network’s data portal.

“There is an important and growing partnership between CDC-funded state tracking programs and laboratories interested in biomonitoring,” said Jean Johnson, PhD, supervisor, environmental epidemiology unit, and director, environmental public health tracking and biomonitoring program, at the Minnesota Department of Health. “CDC tracking programs bring the environmental epidemiology piece that is a critical resource for state laboratories interested in population-based biomonitoring.”

Integrating Biomonitoring with CDC’s National Environmental Public Health Tracking Program | www.aphlblog.org

Identifying Environmental Health Surveillance as a Priority

The Tracking Network was established in response to a 2000 Pew Environmental Health Commission Report, which revealed a fragmented surveillance system. Information gaps and data silos prevented scientists from connecting data on environmental exposures with chronic disease data.

“The consensus was that, if we created surveillance for environmental health, we would do a much better job connecting environmental hazards and exposures to Americans’ health,” said Johnson.

In 2002, CDC funded the new surveillance program that is typically referred to as the Tracking Network. Sixteen states were brought on board to systemically collect, analyze and disseminate environmental public health data. Since that time the network has grown to 23 states plus New York City and several academic partners. The participating states pull the data together by identifying and exploring existing data sources. Epidemiologists analyze the data for trends and spatial patterns. The academic partners then take a research angle, examining the data for connections.

There are approximately 15 content areas tracked in each state, including air quality, drinking water, chronic disease from cancer registries, heart disease, and carbon monoxide poisoning. In most states, children’s blood lead levels are the only biomonitoring data that have been tracked systematically, although federal support for blood lead surveillance in the states was recently cut.

All of this data is available to the public on web portals. “That’s an important part of tracking too because it’s not just states that use the data,” said Johnson. “Universities, advocate organizations, community and local public health folks: if it’s public data, it’s accessible to everyone who wants to use it.”

The participating states all agree to track certain things so that the network is supplied with nationally consistent data and measures. Teams from the states first identify what a consistent measure is, and then provide the data to CDC and post it to the public portals. Yet states are also free to add supplemental information that may be particularly relevant to their region.

“This program has really helped build significant environmental epidemiology capacity in state health departments,” said Johnson.

Taking Environmental Health Surveillance a Step Further by Adding Biomonitoring Data

In 2011, network participants decided to investigate whether any of the biomonitoring work conducted in the states was consistent enough to allow for national tracking of the data. The Biomonitoring Task Force was established, and it developed and sent a survey to the 23 states in the tracking program. The survey asked the states to review the past 10 years of available biomonitoring data to identify what analytes were tested, how, on what populations and with what kind of funding. Essentially the network was searching for consistencies that would make a particular chemical (in populations) trackable on a national platform.

In the survey, biomonitoring testing was split into five categories:

1) Mandatory report data: some states require hospitals or clinics to report poisonings or chemical exposures

2) Population-based survey: surveillance to measure spatial or temporal differences in population exposure or to evaluate the efficacy of public health actions to reduce exposure (for example, any state programs similar to NHANES)

3) Targeted public health investigation: in response to community health concerns about contamination or a disease cluster (drinking water contamination)

4) Rapid response: in response to an emergency situation, such as a chemical emergency in a school or community

5) Support of academic research project: providing laboratory support to academic institutions

Overall the results (see slide image below) reveal that there is very limited consistency among state biomonitoring programs, which would make it difficult to enter the data into a national tracking program. Very few of the studies use probability-based population sampling methods, meaning that researchers cannot generalize the results outside of the tested group.

Johnson pointed out that each state likely has more biomonitoring data than was identified in the survey since a lot of work never gets reported or published in peer-reviewed journals.

The survey results made it clear that the state tracking grantees want to build their biomonitoring programs. However, there is a significant lack of sustained resources to support state biomonitoring work.

The next activity on the task force’s agenda is to write a white paper to describe the current limitations posed by the existing data, and recommend strategies to help create consistent data across the country.

In the years to come, as states develop their biomonitoring programs, it will be important to work with the tracking network so that this valuable data is accessible and useful to anyone who needs it.

Without biomonitoring, public health practitioners face challenges in understanding whether environmental contaminants are actually being absorbed into people’s bodies. Given improvements in technology, the capabilities and expertise that exist in public health laboratories, and the increasing demand from the public for more information about chemical exposures, biomonitoring is poised to become an integral component of public health practice.

To learn more about biomonitoring, check out some of APHL’s Biomonitoring Resources:

Stay tuned for our soon-to-be-unveiled Meeting Community Needs page and of course, let us know if you have any feedback or suggestions.  

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APHL’s Top 10 Blog Posts of 2013

Dec 19 2013 :: Published in General

APHL had an exciting year!  Here are the ten blog posts that attracted the most readers this year.  As you’ll see, there’s a big focus on newborn screening thanks to our 50th Anniversary campaign.  We’d like to offer a special thanks to the many families who shared these inspirational stories!

APHL's Top 10 Blog Posts of 2013 | www.aphlblog.org

10. Proof of the Value of Newborn Screening at Every Milestone – Joe is an adorable blue-eyed dimpled little boy who loves math.  But after learning their perfect new baby had PKU, Joe’s parents worried.  A doctor assured them, “He can have the greatest life.”  And he has.

9. Screening Scores Big for These Minnesota Twins – Sam and Grace were both born with PKU.  Their parents were saddened to think of all the exciting food-related things they might not get to do – no hot dogs at ballgames or ice cream cones in the summertime.  Eventually they came to appreciate the diagnosis and understand what missing this important information might have meant. “We are so lucky and fortunate that our children were born in a time and place where a simple test saved their lives,” said their mother, Becca.

8. Anthrax in Minnesota? The Laboratory Response Network Springs into Action – After a several-week long road trip, a man became severely ill.  What was causing the illness and how many people might he have infected along the way?  The Minnesota lab jumped into action and solved this public health mystery.

7. Two Siblings Born With Isovaleric Acidemia: One Caught by Newborn Screening, One Wasn’t – The Monaco family’s experience is a perfect example of why newborn screening is so critical.  One of their children was born at a time when his disease was not on their state’s screening panel; another one of their children was born at a time when her disease, the same as her brother’s, was on their state’s screening panel.  Their outcomes are dramatically different, all because of newborn screening.

6. No Story Is the Best Story – Honey emailed us to share photos of her daughter, Maren, during our 50 Years of Saving Babies’ Lives campaign.  She mentioned that Maren has a condition that was detected by newborn screening, and because of this early detection they were never a family in crisis and do not have a scary, dramatic story.  Her story – or lack thereof – struck many of us at APHL.

5. A Pediatrician’s Quick Thinking Saved Maggie Grace – Maggie seemed like a typical newborn to her first-time-parents.  As they all prepared to leave the hospital, something happened and Maggie was sent to the NICU.  Luckily, her pediatrician had the foresight to contact the state public health lab and have Maggie’s newborn screening results rushed.  That decision may have saved her life.

4. What Exactly Does the Shutdown Mean for Public Health? – The federal government shutdown had sweeping impacts across the nation.  But what did it mean for the many critical federal public health programs?  Luckily state and local programs were still hard at work, but they were missing an integral part of the public health system.

3. PKU Hasn’t Stopped Elisa From Living Her Dreams – Elisa was born with PKU; fortunately for her it was detected by newborn screening at birth.  Now an adult, Elisa has traveled the world, gotten married and had a baby of her own.  “PKU can’t stop you from living your dreams… I’m excited for life.”

2. On the Verge of a Coma, Baby Carter’s Life was Saved – Carter was born just before Thanksgiving. As his parents prepared to host family for the holiday, they got a call that his newborn screening results were abnormal.  Carter has Maple Syrup Urine Disease (MSUD), and, within those first days of life, was literally hours from slipping into what could’ve been a damaging coma.  Now Carter is a typical rambunctious tot who keeps his family very busy!

The most read blog post of 2013… It’s a tie!

1. Federal Public Health Programs and Employees are Essential Despite Label – During the federal government shutdown, employees were referred to as “essential” and “nonessential” as a designation of who was furloughed and who was required to work.  As APHL’s executive director, Scott Becker, pointed out, ALL public health workers were essential whether furloughed or not.

1. Tap Water vs. Bottled Water – Do you drink tap or bottled water?  One of APHL’s environmental health staffers explained why bottled water many not be any better than tap.  It might have you thinking twice about buying that expensive bottle of water!

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