Lab Matters Fall 2017 | Page 4

president’ s message

When I first heard about biomonitoring early in my public health career, I was intrigued and amazed by the scientific brilliance of the concept.

It was not simply the ability of modern instruments to detect and accurately quantify the ultra-low concentration of environmental chemicals in blood or urine, remarkable as it was for any scientist. I was even more impressed by a new integrative concept— the ability to obtain the totality of environmental exposures( or more accurately“ body burden”) for an individual with a single test. Instead of having to come up with separate, difficult measurements of a given contaminant in air, water and food, and use complex modeling algorithms, with a ton of assumption, and end up with an approximation of what a person was exposed to, we can now tell everyone how much of a chemical they absorbed by measuring it directly in their body fluids!

While the full potential of this concept is still to be realized— and, as it always is in science, not quite as simple as it sounds— we are now closer than ever before to bringing biomonitoring to all states.

The diagnosis of lead poisoning by determining the blood lead concentration is the most widely known example of biomonitoring. Perhaps because it has been in the public health field for so many decades, it has become a stand-alone program, seemingly without a clear connection to the rest of the biomonitoring efforts. It has become automatic in many states with universal screening requirements to test children for lead and compare their level to CDC-defined reference levels without necessarily thinking this is biomonitoring. It’ s a blood test, one of many a doctor can order, and you get it from any medical lab. Surprisingly, it is the“ emerging” contaminants with undefined reference levels and unclear health effects that make people want to know whether these chemicals might be present in their bodies.

In the last few years, there have been several instances of states dealing with the problem of drinking water wells contaminated with per- and polyfluoroalkyl substances( PFAS). These substances are normally not monitored for in drinking water, and the discovery of a significant PFAS contamination in a community usually comes as a shock to residents, and sometimes to government officials as well. The response to such recent events in New Hampshire, New York and Vermont involved biomonitoring tests provided by federal and / or state laboratories, with a great deal of anxiety and learning involved. Given the relative novelty of the approach, I was very surprised when during the discussion of planned surveillance of drinking water wells for PFAS in Rhode Island, it was one of the environmental agency officials who said“ Are you going to have to do these blood tests, too”? While the tone of his question left no doubt about what he was thinking of these“ blood tests”— and his hope it would not go that far— the fact that he knew this possibility existed and how it could be used left me smiling.

Over the past decade, APHL’ s Environmental Health Committee spent a lot of effort convincing state environmental health directors and other stakeholders that biomonitoring is a core function of public health. Position statements and fact sheets were written and distributed, but not much was happening in states without direct access to biomonitoring funds. Thanks to several years of federal funding given to states for biomonitoring efforts, more and more public health officials became conversant in this field.

This year, we have another milestone: the National Biomonitoring Network is being launched, helping link laboratories with interest in biomonitoring increase their capabilities to perform sound biomonitoring measurements and conduct scientifically valid biomonitoring studies. You can read about the Network elsewhere in this issue. n

Over the past decade, APHL’ s Environmental Health Committee spent a lot of effort convincing state environmental health directors and other stakeholders that biomonitoring is a core function of public health.”

– Ewa King, PhD