Lab Matters Fall 2017 | Page 12

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Maine has a higher rate of bladder cancer than New Hampshire and , in both states , it is linked to arsenic exposure . Uranium was added to the study based on past research showing that it tends to co-occur with arsenic .

One of the most interesting aspects of the New Hampshire study is the public health laboratory ’ s outreach to recruit participants . Amanda Cosser , MPH , the laboratory ’ s biomonitoring program manager , said “ We identified towns we want to target based on groundwater arsenic risk modeling from the US Geological Survey and picked a random set of addresses with private wells . Then we introduce the project with a postcard that gives three ways to contact us : call , e-mail or complete an online survey . If they don ’ t respond , we follow up with a formal letter .”

Additional outreach comes through the involvement of town administrators , managers and selectmen . After meeting with laboratory staff , said Cosser , “ they ’ ve taken it upon themselves to advertise our study in their town letters and on their websites .”

So far , 375 well water users have joined the study .

Another CDC-funded study is underway at the Virginia Division of Consolidated Laboratory Services ( DCLS ), under the direction of Chris Retarides , PhD , and Shane Wyatt , the lab ’ s lead biomonitoring scientists . The focus here is two-part : ( 1 ) a surveillance survey to determine baseline , local exposures to six heavy metals and perchlorate ( a naturally occurring contaminant in fertilizer and a rocket fuel constituent , linked to thyroid disease ) and ( 2 ) an assessment of firefighter ’ s exposure to toxic combustion products , including polycyclic aromatic hydrocarbons ( PAHs ) produced by burning wood and cyanide produced by burning plastics .

“ If we see high levels of PAHs and very low levels of cyanide , we know the exposure was mostly dermal ,” said Retarides , since PAHs can be absorbed through the skin or inhaled , while cyanide is largely inhaled .

As in New Hampshire , community outreach is a key study component . Retarides said the researchers initially considered working through local health

New Hampshire PHL ’ s technical advisory committee ( TAC ) reviews and provides feedback on a draft report package for the Targeted Arsenic and Uranium Public Health Study . Photo : NH PHL

departments to enlist surveillance survey participants , but found health department staff to be taxed with other important duties . Instead , they chose to recruit participants at the Commonwealth ’ s 23 community colleges , knowing that most recruits would be under Virginia ’ s median age of 37 .

Said Retarides , “ It says on the Virginia Community College System webpage that , no matter where you are in the state , you ’ re no more than 30 minutes from a community college .… These are commuter schools ; people go there because they ’ re convenient . And most [ community college students ] are exposed to the local environment and water systems .”

As of late September , the DCLS team had collected over 900 urine specimens for the surveillance survey and completed analyses on about 500 , with no unusual findings thus far . The firefighter study is still ramping up .

A New Frontier : The Exposome

Retarides has high hopes for NBN , which he called “ a great undertaking .” Having been on the periphery of efforts to establish the network , he said , “ I know the people involved are a great treasure trove of knowledge . It will be a big help to states looking for survey methods , analytical methods and epidemiology and analytical chemistry expertise . [ Biomonitoring ] is not just about measuring samples , you have to go out and get them , and the measurements have to be meaningful .”

In addition to providing information and training , network members could also perform testing for other laboratories within or outside NBN , either as part of an emergency response or to support a biomonitoring study . Aldous said , “ It ’ s not just routine testing , but testing for novel compounds that can be disseminated across the network , maybe something in commerce now that people aren ’ t taking great notice of , but that needs to be looked at across the country .”

Julianne Nassif , MS , director of APHL ’ s Environmental Health program , said NBN will focus initially on developing technical guidance for biomonitoring programs , a membership application process and a network structure , with tiers based on a laboratory ’ s capability and activities .

NBN leaders also plan to convene additional workgroups , to begin an initiative on quality management and quality systems , and to investigate options for where to store state biomonitoring data , such as in the EPHT Network maintained by CDC or a new , stand-alone database .

In the meantime , the science of biomonitoring continues to evolve in ways big and small . The latest buzz word in the field is exposome , encompassing the entire universe of one ’ s environmental exposures from the prenatal period onward , together with all the associated biological responses to those exposures throughout the lifespan . Thanks to technological advances , particularly