Lab Matters Summer 2021 - Page 18


New Jersey Laboratory Pioneers Prenatal Lead and Mercury Screening

By Jill Sakai , PhD , writer
While part of the Maryland Department of Health and Mental Hygiene , metals specialist Eric Bind , MPP , took part in a biomonitoring collaboration with the Johns Hopkins University School of Public Health . The project team , seeking to better understand fetal metal exposures and related health outcomes , analyzed blood samples collected at birth from mothers and babies for lead , mercury and other toxic metals .
The study revealed a clear relationship between metal exposures in mothers and their babies .
“ The one thing that really struck me , though , was that there was nothing we could do about it ,” Bind recalled . “ These were samples that were collected maybe 10 years ago , in Boston — out of our jurisdiction — and there ’ s nothing we could really do other than to let people know there ’ s a problem .”
That memory was fresh in his mind two years later when , as the Metals Laboratory supervisor at the New Jersey Public Health and Environmental Laboratories , he helped apply for a CDC biomonitoring grant to support prenatal lead and mercury screening in the state . “ I saw the opportunity to not only test , but to actually expand it to the point where we can do interventions ,” Bind said .
Metals exposure , especially early in life , is linked to a host of neurological problems and developmental disorders . Early testing can have lifelong effects , but “ this testing isn ’ t being done , especially for mercury ,” said Andrew Steffens , PhD , a metals chemist in the New Jersey laboratory .
“ There was a gap here and that needed to be addressed .”
The New Jersey Prenatal Screening team . Back row ( from l to r ): David Riker , Shatal Patel , Eric Bind , Dr . Thomas Kirn , Katelin Dittmar , Dr . Andrew Steffens . Front row ( from l to r ): Brian Hontiveros , Veronica Chandra , Latasha Blue , Dr . Zhihua ( Tina ) Fan , Ana Gross , Sharon Robinson , Lauren Lettiere , Debbie Hargrave
for more than two years , and the city has large populations of immigrant , non-white and low-income residents — groups that are often more vulnerable to metal exposure . But talks with numerous potential partners fizzled due to high rates of personnel turnover at clinics , limitations on research involvement , challenges with patient recruitment and consent , high staff workloads and questions of who would provide and pay for treatment .
Not to mention , the laboratory team was challenging the status quo .
“ There was no precedent anywhere in the country . I never really appreciated how much precedent matters ,” Bind said . experience screening for lead in pregnant women in New York City and hoped to start a similar program in New Jersey .
Nwobu and Onajovwe Fofah , MD , a neonatologist and associate professor in the Department of Pediatrics , saw value in pursuing the project as a public health initiative . They integrated the metals screening and any needed treatments as part of the standard care for all expectant mothers and newborns at the school ’ s main teaching hospital , University Hospital .
“ Every mother who seeks prenatal care in our practice has lead and mercury tested , and then the babies and mother at the time of delivery ,” Fofah said .
Forging a New Path
New Jersey seemed an ideal location for such a project . Newark , in particular , had been actively addressing elevated lead levels in the municipal water system
At last , the laboratory team found champions at Rutgers New Jersey Medical School in Newark . Uchenna ( Chris ) Nwobu , MD , an assistant professor in the Department of Obstetrics , Gynecology and Women ’ s Health , had some previous
The team relies on a network of partnerships to address exposures both medically and environmentally . At a woman ’ s first prenatal visit , the hospital collects a blood sample that goes to the state laboratory for lead and mercury
16 LAB MATTERS Summer 2021
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