The Indiana laboratory system: focus on environmental laboratories.

The Indiana State Department of Health (ISDH) Laboratories are working to improve Indiana's state public health laboratory system. Environmental laboratories are key stakeholders in this system, but their needs have been largely unaddressed prior to this project. In an effort to identify and engage these laboratories, the ISDH Laboratories organized and hosted the First Annual Environmental Laboratories Meeting. The focus of this meeting was on water-testing laboratories throughout the state. Meeting objectives included issue identification, disaster recovery response, and communication efforts among system partners. Common concerns included the need for new technology and updated methods, analyst training, certification programs for analysts and sample collectors, electronic reporting, and regulation interpretation and inspection consistency. Now that these issues have been identified, they can be addressed through a combination of laboratory workgroups and collaboration with Indiana's regulatory agencies. Participants were overwhelmingly positive about the meeting's outcomes and were willing to help with future laboratory system improvement projects.

Implementation of routine access to herpes simplex virus type 2 antibody testing in a public health sexually transmitted disease clinic.

BACKGROUND: Testing for herpes simplex virus type 2 (HSV-2) antibody is not common in clinical practice. Client characteristics associated with HSV-2 rapid antibody test uptake and test positivity were analyzed in clients attending an urban sexually transmitted disease clinic. METHODS: This optional test was available for $30. The HerpeSelect Express assay was performed on serum. Demographic and behavioral characteristics were compared between clients who requested testing and those who did not and between those who were HSV-2 antibody positive and negative. RESULTS: In 4 months, 3498 individuals attended the clinic and 443 (12.7%) opted for HSV-2 testing. Clients who were black, younger, or female were less likely to request testing. Recent sexual behavior and self-reported sexual orientation were not associated with uptake of testing. Of the 442 clients with results available, 109 were positive for HSV-2 antibody (24.7%). Women were significantly (P <0.001) more likely to test positive; 42 of 111 (38.4%) versus only 67 of 331 (20.2%) men. A positive HSV-2 antibody test was also associated with increasing age and black race. There was an association with the number of partners in the last 30 days, but no association with the number of partners in the last year. Of the 109 clients who had a positive HSV-2 antibody test, 71 (64.5%) accepted a prescription for suppressive acyclovir therapy. CONCLUSIONS: Uptake of testing was modest in this population, especially among the highest risk individuals, possibly due to the cost of the test. Improved education regarding HSV-2 and subsidized testing may be needed in the populations that have the highest prevalence in order to encourage testing.

Blood lead levels in NASCAR Nextel Cup teams.

This pilot study determines whether NASCAR racing teams demonstrate exposure to lead from exhaust by evaluation of blood lead levels (BLL). Participants were stratified by proximity to fuel exhaust or whether they worked on an engine. Each participant completed a self-reported survey recording demographics, lead exposure (occupational or in-home environment), and any physical symptoms of lead toxicity. Blood lead levels were then measured. BLL of 47 individuals ranged from 1-22 microg/dL with a median of 9.4 microg/dL. Nineteen of 47 (40.4%) had BLL > or = 10 microg/dL. Participants exposed to exhaust gas had the highest relative risks (RR) for elevated lead, followed by working on brakes and radiator repair. The RR of having an elevated BLL and self-reported adverse health outcomes or symptoms was increased. This study of NASCAR racing teams demonstrates lead exposure.