APHL 2019 POSTER ABSTRACTS
Water Quality Results: In Arkansas, 14 childcare facilities were
identified to use private wells and 50% used chlorinators.
Interestingly, 5 facilities had access to public water but had not
connected to public water due to the cost. No facilities tested
positive for E. coli, but 4 facilities were positive for total coliforms.
Several facilities had detectable levels of chloride, nitrate,
phosphate, and sulfate, but all levels were below the maximum
contaminate level (MCL) set by the Environmental Protection Agency.
One facility had naturally occurring fluoride. Five of the facilities had
acidic water, which could lead to corrosion of the plumbing.
Conclusion: This pilot study was the first of its kind in Arkansas to
be an inter-agency study as well as bring several different areas of
the Arkansas Department of Health together. Also, this study was
the first to investigate well water quality in Arkansas. Although the
study was small, the collaborations established have continued and
further studies have been planned.
Presenter: Katie Seely, Arkansas Public Health Laboratory, Little
Rock, AR, [email protected]
Enhanced Opioid Overdose Surveillance in the US
D. Mustaquim, Centers for Disease Control and Prevention
The opioid overdose epidemic was declared a national emergency
in 2017, following dramatic increases in opioid overdose in several
areas of the country. Understanding changing trends in overdoses
involving prescription and illicit opioids as quickly as possible is
essential to deploying effective public heath interventions to reduce
morbidity and mortality. Currently, 32 states and Washington DC are
funded to perform enhanced opioid overdose surveillance activities
through the Enhanced State Opioid Overdose Surveillance (ESOOS)
cooperative agreement.
The goals of ESOOS are to: 1. Increase timeliness of non-fatal
opioid overdose reporting, 2. Increase timeliness of fatal opioid
overdose reporting, and 3. Increase dissemination of data to key
stakeholders. Enhanced fatal opioid overdose surveillance is
based on the State Unintentional Drug Overdose Reporting System
(SUDORS), which leverages the National Violent Death Reporting
System (NVDRS). SUDORS often includes detailed toxicology
testing results, along with data from death certificates and medical
examiner/coroner reports. Laboratory data is a critical element
of this system and testing is done by a variety of laboratory types,
including public health laboratories. Non-fatal opioid overdose
surveillance in the US is based on monitoring of emergency
department data for indicators of overdose based on chief
complaint and discharge diagnosis data (syndromic surveillance)
and also hospital discharge data. This does not include laboratory
testing data. Laboratory testing is one way to determine what
specific drugs are being used and if and how these drugs evolve
over time (e.g., new analogs for substances like fentanyl). Some
laboratory data sources are emerging that could potentially fill this
gap in surveillance, including public health laboratory surveillance
testing and commercial laboratory testing.
This poster will explain these components of enhanced national
opioid overdose surveillance in more detail. The most recent findings
from enhanced surveillance activities will be shared, including recent
trends and emerging areas of concern. Laboratory data sources being
evaluated to supplement nonfatal opioid overdose surveillance will be
highlighted as well as their respective strengths.
PublicHealthLabs
@APHL
APHL.org
Presenter: Desiree Mustaquim, Centers for Disease Control and
Prevention, Atlanta, GA, [email protected]
State Approaches to Participant Recruitment, Sample
Collection, Surveying, Results Return and Evaluation in
Biomonitoring Investigations
L. Parcels and K. Dortch, Centers for Disease Control and Prevention
The Centers for Disease Control and Prevention’s (CDC) State
Biomonitoring Program aims to increase the capability and
capacity of state public health laboratories to conduct high-
quality biomonitoring science and assess human environmental
exposures in their communities. With financial and technical
assistance from CDC’s Division of Laboratory Sciences (DLS), state
programs purchase laboratory equipment and supplies, hire and
train specialized staff, and conduct fieldwork and data analysis.
Awardees under the current cooperative agreement include
California, New Hampshire, New Jersey, Massachusetts, Virginia,
and the 4 Corners States Biomonitoring Consortium (Utah, Arizona,
New Mexico, and Colorado).
States face many challenges as they develop and implement
biomonitoring approaches, including recruitment and selection
of a representative sample, survey design and sample collection,
results reporting, data management, and program evaluation.
Many address these challenges by leveraging funding resources
(i.e., in-kind, state, and federal resources) and developing strategic
partnerships to strengthen biomonitoring activities. At the State
Biomonitoring Programs Annual Awardee Meeting in Atlanta in
November 2018, awardees expressed interest in sharing methods
for overcoming the obstacles associated with designing and
implementing high-quality biomonitoring studies. This summary
aims to assemble states’ approaches to increase awareness of
successful strategies and stimulate new efforts for recruitment,
sample collection, survey design, results return, and evaluation.
Presenter: Linde Parcels, Centers for Disease Control and
Prevention, Atlanta, GA, [email protected]
Trace Metals Lot Screening of Sample Collection and
Storage Devices Used in Biomonitoring Studies
C. Ward, R. Williams, N. Hilliard and R. Jones, Centers for Disease
Control and Prevention
The Centers for Disease Control and Prevention’s Inorganic and
Radiation Analytical Toxicology Branch uses inductively coupled
plasma mass spectrometry to measure levels of metals such
as zinc, copper, selenium, antimony, arsenic, barium, beryllium,
cadmium, cesium, chromium, cobalt, iodine, lead, molybdenum,
manganese, mercury, nickel, platinum, strontium, thallium, tin,
tungsten, and uranium in human clinical specimens. A common
assumption is that materials such as needles and cryogenic vials
and tubes used in the laboratory are free from contamination;
however, that is not necessarily the case especially for metals
analysis at population based biomonitoring levels. Lot screening
is critical for determining accurate population reference levels of
screened metals that tend to be at the very low concentration end of
the analytical range in clinical specimens.
Our branch has a dedicated lot screening laboratory that uses
ICP-MS to detect the absence or presence of metal contaminants
Summer 2019 LAB MATTERS
41