Four Corners States Biomonitoring Consortium: Lessons Learned During Implementation.

Building on a history of collaboration in environmental public health and biomonitoring activities, laboratory and environmental epidemiology leaders in Arizona, Colorado, New Mexico, and Utah created the Four Corners States Biomonitoring Consortium, which is now in its third year of activities. In this article, we briefly highlight some lessons learned during the implementation phases of the consortium, including the processes of collaborating to identify common environmental exposure concerns, prioritizing those concerns, identifying cohorts and communities with potential risks of excessive exposure, developing a model for conducting exposure investigations, and the challenges presented during the implementation phases and early fieldwork activities. Detailed information on these topics can be found at www.4csbc.org. The advantages of collaborating with, and leveraging the resources of, state Environmental Public Health Tracking Networks and Public Health Emergency Preparedness programs are discussed. Using one example from the early stages of this work, we also discuss the potential of biomonitoring as a vehicle for empowering the public to make informed choices to control their exposures and to influence public health decisions, support science-based environmental health policy and program development, and respond to emerging environmental exposure concerns.

Advancing environmental health surveillance in the US through a national human biomonitoring network.

The United States lacks a comprehensive, nationally-coordinated, state-based environmental health surveillance system. This lack of infrastructure leads to: • varying levels of understanding of chemical exposures at the state & local levels • often inefficient public health responses to chemical exposure emergencies (such as those that occurred in the Flint drinking water crisis, the Gold King mine spill, the Elk river spill and the Gulf Coast oil spill) • reduced ability to measure the impact of public health interventions or environmental policies • less efficient use of resources for cleaning up environmental contamination Establishing the National Biomonitoring Network serves as a step toward building a national, state-based environmental health surveillance system. The Network builds upon CDC investments in emergency preparedness and environmental public health tracking, which have created advanced chemical analysis and information sharing capabilities in the state public health systems. The short-term goal of the network is to harmonize approaches to human biomonitoring in the US, thus increasing the comparability of human biomonitoring data across states and communities. The long-term goal is to compile baseline data on exposures at the state level, similar to data found in CDC's National Report on Human Exposure to Environmental Chemicals. Barriers to success for this network include: available resources, effective risk communication strategies, data comparability & sharing, and political will. Anticipated benefits include high quality data on which to base public health and environmental decisions, data with which to assess the success of public health interventions, improved risk assessments for chemicals, and new ways to prioritize environmental health research.

Pilot study for utilization of dried blood spots for screening of lead, mercury and cadmium in newborns.

The exposure of pregnant women and young children to environmental pollutants is an ongoing concern of state and local public health departments. Of primary concern is the exposure to lead in lead-based paints, methyl mercury in contaminated fish and cadmium present at mining sites. The feasibility, utility and methodology of using blood spot cards collected for new born health screening purposes was studied for use in conducting routine state-wide surveillance of blood lead, mercury and cadmium levels in infants. Homogeneity of different lots of blank filter paper was examined. Mass measurements (weights) of filter paper punches were taken across three different lots of filter paper. Statistical analysis of the data was performed using one-way ANOVA, which indicated no significant difference in the means of all three lots, but high variances were noted. The three metals were examined in three different lots of filter papers purchased from the manufacturer. The lots had measurable amounts of cadmium and lead, but not mercury. Lead spike values were observed for roughly about 7% of the blank samples, indicating heterogeneous distribution of this metal. Statistical analysis of the data was also performed using a two-way ANOVA calculation with Tukey's pairwise comparisons. The results found that total mean metal loadings across the three lots were different. The concentration of the metals can be different from each other and the concentration of any one metal can differ across lots. Stability at different concentrations of the heavy metals in blood spotted onto filter paper with time and storage conditions was examined. Results indicate acceptable performance for at least 8.5 months for lead (near CDC's concern level) and for mercury (near NRC's concern level). The filter paper and blood spots were analyzed for metals using an acid extraction, followed by analysis using an inductively coupled plasma mass spectrometer (ICP-MS). Blood spot cards were studied from four different states across the Rocky Mountain region. Internal blank punches adjacent to the blood spot and actual dried spot punches from the same card were analyzed simultaneously. The blank punch indicated the amount of contamination present in the blood spot sample. Statistical analysis of the data was performed using MANOVA followed by calculations for each metal separately. This method was found to be suitable for assessing maternal exposure to lead and mercury using residual newborn screening specimens. Additional research into the applicability for cadmium is needed. Because of the intrinsic problem of contamination from the skin surface of capillary blood samples or other internal or extraneous sources, automatic re-analysis of elevated results assures minimal false positives are reported.

Interlaboratory bias in the determination of mercury concentrations in commercially available fish utilizing thermal decomposition/amalgamation atomic absorption spectrophotometry.

Four commercially available fish fillets were freeze-dried, homogenized, and analyzed for mercury by the Texas A&M Trace Element Research Laboratory and the Utah Public Health Laboratory (UPHL) utilizing thermal decomposition/amalgamation atomic absorption spectrophotometry. Two-way analysis of variance detected bias in the data between the two laboratories. Some of the bias could be attributed to different calibration curve quantitation and near detection limit quantitation, albeit causal explanations could be confounded with other effects. Knowledge of analytical bias will aid interpretation of interlaboratory data. The swordfish mercury content, as determined by both laboratories, was about 1 ppm, while mercury content found in the Atlantic salmon was about 0.021 ppm. For the Alaskan halibut, the Texas A&M measured a mercury concentration of 0.155 ppm, while the UPHL measured a mercury concentration of 0.181 ppm for the same fish. The Texas A&M determined that the Canadian-raised salmon contained about 0.019 ppm of mercury, while the UPHL determined a mercury content of about 0.025 ppm for the same fish. The mercury found within the fish fillets did not exceed nationwide mercury mean values determined by the U.S. Food and Drug Administration.

A detailed study of thermal decomposition, amalgamation/ atomic absorption spectrophotometry methodology for the quantitative analysis of mercury in fish and hair.

The analytical method for determining the concentration of mercury in fish by thermal decomposition, amalgamation/ atomic absorption spectrophotometry was thoroughly studied. Specific issues addressed were accurate modeling of instrumental response, the use of quartz and nickel boats, carryover effects, software limitations, and troubleshooting. The DMA-80 Direct Mercury Analyzer instrument was calibrated using a total of 22 points, and the resultant curves statistically analyzed. At minimum, second-order polynomials were required to adequately model the data. TORT-2 standard reference material was analyzed in both quartz and nickel boats and found to give equivalent performance in both types of vessels and well within the 95% confidence interval. DOLT-3 standard reference material also yielded values well within the 95% confidence interval, but the DORM-2 standard reference material did not. Carryover effects were found to be minimal with a new catalyst tube but increased with catalyst age. Blanks should be run after the analysis of high mercury content samples; however, when the catalyst has aged, two blanks are required to reduce apparent mercury signals to nominal blank values. Comparable results between thermal decomposition, amalgamation/atomic absorption spectrophotometry and cold-vapor atomic absorption spectrophotometry were demonstrated. The feasibility of using this instrument to analyze hair was also explored and found to be suitable. Software problems and limitations have been noted when attempting to implement a high-throughput methodology. Instrumental drift was found to be minimal when operated over long periods. Blank values can provide important diagnostic indicators.