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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Public Health Thank You Day: APHL Says Thanks!

Nov 25 2013 :: Published in General

Today is Public Health Thank You Day (#PHTD)!  APHL has so much to be thankful for — mostly, we want to say thanks to our members, partners and staff for their hard work protecting the public’s health every day.  We are grateful to be part of this community!

Public Health Thank You Day: APHL Says Thanks! | www.aphlblog.org

Some APHL staff  members have put together messages saying what they are thankful for this #PHTD

I’m always thankful for the dedicated APHL members who give so much of their time and expertise to improving public health nationally, even when they have so much to focus on in their own cities and states.  This year, I am particularly thankful for the opportunity to fully vaccinate my infant twins; the efforts of Luminex to launch a new technology without harming public health; the dedication of friends working logistics routes in the Philippines to help those affected by Typhoon Haiyan; and anything being done to maintain a functioning and effective federal government – open for the business of improving and saving lives.

- Shari Shea, Director, Food Safety

I am thankful for a Customer Support Team that is kind, enthusiastic and dedicated to helping APHL members!

- Susan Bailey, Manager, Customer Support Program

I’m thankful for all the dedicated, hardworking people in public health who keep me, my family, and my community safe and healthy.  I am thankful for clean air, clean water, good soil that my CSA can grow my veggies, and mostly for healthy babies.

- Scott Becker, Executive Director

I am thankful for all of the students who have discovered science can be a life-long passion. It is exciting to learn that the younger generations are finding laboratory science can be an excellent career to serve the needs of their family, friends and the public at large. I am thankful for all of those working to promote laboratory science as a career that impacts the health of the public. Kudos to those who work behind the scenes to keep us safe and healthy!

- Cathy Johnson, Manager, Leadership and Management Curriculum, National Center for Public Health Laboratory Leadership

I am thankful that I get to support all of the wonderful programs that make a difference in people’s lives both here and all over the world.

- Joshua Zulauf, Associate Specialist, Contracts

My thanks to public health labs for saving me from influenza’s fever, aches and pains. They keep me healthy by helping to identify the circulating strains included in each year’s flu vaccine.

- Jody DeVoll, Director, Strategic Communications

I’m thankful for working in a field that is helping to make the world a better place; full of dedicated, smart, caring people; so reliant on science, yet so connected to the people; and always open to learning and new directions.

- Megan Latshaw, Director, Environmental Health Programs

Thank you to all of our staff, members and consultants for the great work they do both domestically and internationally. In a recent trip to Vietnam, I was reminded of how APHL’s work is far reaching. It was inspiring to see how laboratory information management systems are changing the way laboratories here in the US and in countries such as Vietnam and Guyana protect the public’s health.

- Chris Mangal, Director, Public Health Preparedness and Response 

I just spent a few days with my grandson – a healthy, happy, and very rambunctious 5 year old.  I am thankful for all the public health programs that work to keep him healthy – newborn screening assuring that if he had been born with any heritable diseases they would have been detected and treated early;  immunizations protecting him from hepatitis, pertussis, measles, mumps, rubella, rotavirus and more; environmental health looking out for the air he breathes and the water he drinks; food safety and nutrition (together with his parents) watching out that the food he eats is not only nutritious, but free of disease causing bacteria.  Kids are all so precious.

- Jane Getchell, Senior Director, Public Health Programs

 

I am thankful for having the opportunity to work with so many inspiring, dedicated public health professionals that work tirelessly to help keep the whole world healthy both in mind and body!

- Patina Zarcone, Director, Informatics and Institutional Research

 

I am thankful for all the lab techs pipetting away to check for our safety every day. Public health never stops and I am grateful for those who work around the clock. Others’ wellbeing is their constant calling, public health professionals are so ballin’. THANK YOU!

- Caprice Retterer, Associate Specialist, Website

I’m thankful for cold weather, sunny days and public parks for running. Staying healthy through the holidays!

- Ruhiyyih Degeberg, Specialist, Newborn Screening and Genetics

I’m thankful for vaccinations that keep my family safe from serious diseases and for newborn screening programs that save babies’ lives every day.

- Michelle Forman, Senior Specialist, Media

I’m thankful for all public health initiatives geared towards ensuring an integrated food safety system.

- Dare Akingbade, Manager, Food Protection

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Biomonitoring, Tracking and Keeping You Healthy

Oct 24 2013 :: Published in Environmental Health

By Surili Sutaria Patel, MS, Senior Specialist, Environmental Health, APHL

There are multiple ways the environment – the air we breathe, the water we drink, the food we eat and the places we learn, work and play – influences our health. By measuring hazardous substances in our environment we can gain a better understanding of how we can reduce our exposures and prevent health problems in the future.

Biomonitoring, Tracking and Keeping You Healthy | www.aphlblog.org

The National Environmental Public Health Tracking Network (or Tracking Network) is a system that tracks all these factors to better understand how the environment is impacting our health. The Tracking Network, headed by the Centers for Disease Control and Prevention (CDC), provides 24 grants to state and local health departments to participate. Each jurisdiction has its own Network, but also feeds data into the National Tracking Network Portal. This lends insight into a variety of health indicators (e.g., air quality, birth defects, cancer, heart attacks, climate change, etc.), across geographic location and time, and more.

Biomonitoring – a tool used to measure hazardous substances once they have entered the body – furthers our knowledge of harmful environmental exposures. By examining blood and urine samples, biomonitoring programs have produced local exposure data identifying potentially-harmful chemicals and toxic substances in the human body. Biomonitoring studies can also compare results to CDC’s national biomonitoring data to learn whether a specific locality is more exposed than the US population.

By connecting tracking and biomonitoring data, states like Washington, Utah and Wisconsin are identifying harmful chemicals in both the environment and the human body. For example, in a webinar titled Environmental Public Health Tracking Meetings Public Health Labs, state environmental health director, Dr. Sam LeFevre outlined how the Utah Department of Health used tracking resources for conducting a state-wide biomonitoring study on lead and mercury exposure in newborn bloodspots. As one of the states that made up the Rocky Mountain Biomonitoring Consortium, and funded by CDC’s Phase 2 Implementation Grant from the Tracking Network, LeFevre and his team use neonatal bloodspots for conducting population surveillance for heavy metal exposure.

They chose metals because Utah is the third largest mining state in the US, with 24 active mines. Utah also has many fishing waters, 19 of which have fish advisories due to high mercury and other harmful metals. A lesson learned during the years Utah had an active child blood lead poisoning program was that the children most affected by lead poisoning were from upper-income families, who lived in homes with backyards made up of soil rich in metal oxides, traced back to their mining history. Now, by conducting biomonitoring on the bloodspots, the Utah Department of Health is painting a more accurate picture of the cause of elevated blood lead and mercury levels in children across the state. To learn more about Utah’s study, please view the free webinar. Here you will also find a presentation on Wisconsin’s tracking and biomonitoring work.

If you would like to share a success story about tracking and biomonitoring, please contact EH@aphl.org.

 

 

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Massive Molasses Mess and the Laboratory Response

This month is National Preparedness Month.  Follow APHL on our blogTwitter and Facebook for preparedness information and discussions all month!

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By Megan Latshaw, Director, Environmental Health Program, APHL

“It was shocking because the entire bottom is covered with dead fish. Small fish, crabs, mole crabs, eels. Every type of fish that you don’t usually see, but now they’re dead. Now they’re just laying there. Every single thing is dead. We’re talking in the hundreds, thousands. I didn’t see one single living thing underwater.” ~ Roger White, a diver (Massive Molasses Spill Devastates Honolulu Marine Life, NPR)

Massive Molasses Mess and the Laboratory Response) | www.aphlblog.org

We’ve all heard of killing someone with kindness, but who knew that sweetness could deal such destruction? The sweetness comprises almost 250,000 gallons of molasses, spilled into Honolulu harbor on September 9th as it was being loaded into a ship via pipeline.

Because the greatest priority relates to public health, the Hawaii Department of Health is leading the response rather than the US Environmental Protection Agency or the US Coast Guard.

Their State Laboratories Division will be doing bacteria testing (enterococci, clostridium and total).  Since this spill is relatively unprecedented the first two bacterial tests were chosen because 1) Hawaii has a lot of data on them and 2) they are currently used to monitor water quality. Scientists are not sure how the spill will affect these indicators but they theorize that the dead fish and the nutrient-rich liquid could lead to unusual growth in marine algae and harmful bacteria. These data plus some chemistry and physical parameters will help them figure out when things are starting to get back to normal.

Meanwhile, the laboratory expects to run out of supplies for this valuable testing.  They have called upon their peer network to borrow and replace consumables from their labs, on the outside possibility that their suppliers cannot provide them with the necessary materials quickly enough. Such outreach emphasizes the importance of building relationships through networks such as the Laboratory Response Network and the Environmental Response Laboratory Network.

Click the image above for an interview with Hawaii’s public health laboratory director and many of their staff.

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What is the EPA’s Water Security Division?

This month is National Preparedness Month.  Follow APHL on our blogTwitter and Facebook for preparedness information and discussions all month!

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By Michael Heintz, MS, JD, Senior Specialist, Environmental Laboratories

What is the EPA’s Water Security Division? | www.aphlblog.org

As we continue our march through preparedness month, did you know there are people devoted to protecting our water infrastructure?

Before you think, “right, it’s the EPA and they use the Clean Water Act.” While you’re partially right, it is a division within the US EPA, you should know this division works exclusively at protecting drinking water and wastewater treatment plants, pipes, and other physical components of the system. The Water Security Division (WSD) works to prevent, detect, respond to and recover from water hazards. These threats can include purposeful contamination of a drinking water system, a natural disaster, or an accident that threatens the water health of a community.

The WSD has four goals to advance the efforts to protect water infrastructure:

1. Sustain protection of public health and the environment;
2. Recognize and reduce risk;
3. Maintain a resilient infrastructure; and
4. Increase communication, outreach and public confidence.

The WSD works with the nearly 160,000 public water systems (PWS—drinking water distribution), and 16,000 publicly owned treatment works (POTWs—wastewater treatment) to help ensure safe and secure distribution of drinking water and collection and treatment of wastewater. All told, public water systems serve nearly 84%, and POTWs service almost 75%, of the US population. The rest are served by private water systems (like wells) and septic systems

The Water Security Division undertakes a number of activities every year to help ensure the safe operation of the nation’s water infrastructure. The WSD provides resources and programs to address critical issues like intentional contamination, contamination detection, mutual aid, vulnerability assessments, emergency response capabilities, communication strategies, and how to monitor incidents and threats. In addition, the WSD developed a number of tools that drinking water and wastewater facilities can use to increase their own preparedness levels.

One particularly active portion of the WSD is the Water Laboratory Alliance (hey, this is a laboratory blog, after all!). This laboratory-specific portion of the WSD provides laboratories with resources to help them respond to a water security threat. Of particular importance, the WLA provides training and exercise opportunities, communication outlets, and tools for emergency response. The WLA Response Plan goes so far as to outline the steps laboratories should undertake when responding to a water emergency.

With all of these resources at their disposal, drinking water and wastewater systems should be well prepared for an emergency scenario. If you have questions about your water systems, you can contact EPA at the Safe Drinking Hotline either via email or at 800-426-4791. Or, review the Hotline Reports to see answers to prior questions. Your individual utilities can also answer specific questions or review the Safe Drinking Water Information System to see what is in your water.

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