Building a Biomonitoring Alliance by Kristin Dortch , MS , health scientist , US Centers for Disease Control and Prevention
An Intra-agency Partnership
CDC ’ s National Report on Human Exposure to Environmental Chemicals and Updates
includes representative biomonitoring data showing the US population ’ s exposure to more than 400 environmental chemicals . However , the National Report does not include data at the state , local , territorial or tribal level , and it does not identify potential geographic areas of exposure concern .
Since 2009 , CDC ’ s Division of Laboratory Sciences
has funded state public health laboratories to implement biomonitoring studies within their jurisdictions to increase the availability of biomonitoring data in new subpopulations . In 2012 , the Tracking Program recognized that state public health laboratories were measuring some of the same chemicals . Because some of the studies used convenience sampling methods , these data could not be displayed on the tracking network for public health surveillance ; the data needed to be representative to appear on the network . To address the various sample collection approaches , program lead Dr . Gonza Namulanda led a biomonitoring work group that included state epidemiologists and representatives from CDC ’ s State Biomonitoring Program to develop guidance and considerations for selecting the appropriate probability sampling design for a population-based biomonitoring study or survey within a state .
The current CDC-funded state-based public health laboratory biomonitoring recipients are also Tracking Program cooperative agreement recipients . During this funding cycle , the state biomonitoring programs are collaborating with their state Tracking Programs to develop probability-based biomonitoring sampling designs . Some Tracking Program recipients collaborate with state public health laboratories in their biomonitoring initiatives , such as with study design support , data visualization or environmental sample collection .
Strategic partnerships are nothing new for many state biomonitoring programs , who are tasked with developing sample collection strategies , collecting samples , analyzing samples and reporting the results . Successful biomonitoring programs partner with subject matter experts such as toxicologists , epidemiologists , statisticians , non-governmental organizations and others to accomplish their goals .
The New Hampshire Biomonitoring Program previously worked with their state tracking program starting in 2014 on the Targeted Arsenic and Uranium Study and successfully displayed an interactive dashboard on the state ’ s tracking portal
. Building off this momentum , the state will continue to display biomonitoring data on the portal .
“ One aspect that makes it a stronger program is having the paired data with biomonitoring and water analysis results and receiving Tracking Program minigrants to cover the cost of water analysis ,” said Amanda Cosser , the New Hampshire Biomonitoring program administrator . “ Participants are surprised by elevated results for arsenic and learn ways to reduce arsenic exposure . They grow the impact of the program because they start sharing knowledge that they learned with everyone they know .”
Bringing It All Together
Biomonitoring programs must collaborate with local community organizations and health departments , which are
Komal Dahya in CDC ’ s Division of Laboratory Sciences programs an automated sample handling instrument to perform complex sample preparation steps for a triglyceride reference method .
CDC partners with state public health laboratories through other programs such as the Laboratory Response Network for Chemical Threats ( LRN-C ) and the Agency for Toxic Substances and Disease Registry ’ s Partnership to Promote Localized Efforts to Reduce Environmental Exposure . State biomonitoring programs that also participate in CDC ’ s LRN-C program are able to leverage their chemical threat preparedness assets such as expert staffing and equipment to address local public health concerns .
instrumental in developing public trust and improving participant recruitment . The NBN and NBN Steering Committee are working to bring biomonitoring to the forefront of environmental health issues . The Steering Committee includes members from multiple state public health laboratories , federal partners and APHL leadership .
“ Communications with participants are unique and community partners are really important with improving those methods ,” says Dr . Jessica Nelson , program director for the Minnesota Biomonitoring Program and an NBN participant . “ The coordinating and planning with partners are instrumental in recruitment and how to share results that will be heard .”
As NBN expands , new partnerships will strengthen the capacity and capabilities of state public health laboratories to report high-quality biomonitoring data that can be used to implement public health policy changes . As communities continue to address the COVID-19 pandemic , these new alliances will remain at the forefront of environmental health issues , ensuring quality biomonitoring to support public health decision making . n
14 LAB MATTERS Fall 2020