Human biomonitoring and policy making - Human biomonitoring as a tool in policy making towards
Human biomonitoring for metals · MinnesotaMinnesotas’s biomonitoring program 2007 Environmental...
Transcript of Human biomonitoring for metals · MinnesotaMinnesotas’s biomonitoring program 2007 Environmental...
Human biomonitoring for metalsHuman biomonitoring for metals: the experience of the Minnesota
Biomonitoring Program
Northland Society of Toxicology Meeting October 22, 2012
Jessica Nelson, MPH PhDEnvironmental Public Health Tracking and
Biomonitoring Program
BiomonitoringBiomonitoring
Human biomonitoring directly measures the g yamount of an environmental chemical (or chemical breakdown product) in people’s bodies.p ) p p
Exposure‐disease modelExposure disease model
Exposure: tive Dose
Media:food, water, dust, air
Exposure:ingestion,inhalation, dermal
Absorbed Dose
gically Effe
ctBiolog
Use in public health practiceUse in public health practice
• Track trends over timeTrack trends over time
• Identify disparities in exposure
• Show whether some exposures are at a level of health concernof health concern
• Evaluate interventions to reduce exposure
• Set priorities for public health action, research and policyresearch, and policy
Minnesota’s biomonitoring programMinnesota s biomonitoring program
2007 Environmental Health Tracking and Biomonitoring(MN Statutes 144.995‐144.998) says MDH shall…
• Conduct a pilot biomonitoring program of 4 projects in p g p g p jcommunities “likely to be exposed” to:– Arsenic – Mercury – Perfluorochemicals (PFCs) – TBD (BPA & parabens)Perfluorochemicals (PFCs) TBD (BPA & parabens)
• Develop recommendations for an ongoing state biomonitoring programb o o o g p og a
Minneapolis Children’s Arsenic Pilot Project
• Measured As in urine of 65 children from Mplsneighborhoods near pesticide storage facility – East Phillips, portions of Ventura Village, Midtown Phillips, PowderhornPark Corcoran Longfellow SewardPark, Corcoran, Longfellow, Seward
– Soil testing conducted by EPA ‘01‐06– Urine samples collected summer ‘08
• Eligibility: age 3‐10, live in homes with soil testingwith soil testing
RecruitmentRecruitment
• Originally contacted 511 properties with soil As > O g a y co tacted 5 p ope t es t so s20 ppm– Sent letter and survey to identify eligible children– 122 households returned survey; 654 visited by staff– Spanish‐ and Somali‐speaking staff40 hild l i l d d id d i– 40 children ultimately consented and provided urine
• Expanded population to include any household with soil testingwith soil testing– Flier (in English, Spanish, Somali) sent by mail– 25 additional children enrolled25 additional children enrolled
Sample collectionSample collection
• Urine collection kits provided to parentsUrine collection kits provided to parents• 2 first morning voids on consecutive daysS d ff ll d i ki• Study staff collected urine kits
• Parents completed short questionnaire• As urinary half life = 4 days
Arsenic analysisArsenic analysis
• Total As measured by MDH PHL using ICP‐Total As measured by MDH PHL using ICPDRC‐MS
• Creatinine measured creatinine corrected• Creatinine measured, creatinine‐corrected results presentedS i d if / i S• Speciated if > 15 μg/g using LC‐ICP‐DRC‐MS– 6 As species, 4 of which are inorganic As
Distribution of Total Urinary ArsenicDistribution of Total Urinary Arsenic
35
25
30
35
hild
ren
Speciation Level 50 µg/g creatinine
ATSDR/CDC level of action
200 µg/g creatinine; health effects at chronic exposure
10
15
20
umbe
r of C
h
0
5
-4 10 14 19 24 29 34 39 44 49 54 59 64 69 74 79 84 89 94 99 04 09 14 19 24 29 34 39 44 49 54 59 64 69 74 79 84 89 94 99
Nu
58.9 155.9 191.3
1- 5-1
11-1
15-1
20-2
25-2
30-3
35-3
40-4
45-4
50-5
55-5
60-6
65-6
70-7
75-7
80-8
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90-9
95-9
100-
1010
5-10
110-
1111
5-11
120-
1212
5-12
130-
1313
5-13
140-
1414
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150-
1515
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160-
1616
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170-
1717
5-17
180-
1818
5-18
190-
1919
5-19
Total Arsenic µg/g creatinine
Total Organic and Inorganic Urinary lArsenic Levels
140
100
120
ne-c
orre
cted
)
Total Organic Arsenic µg/g
Total Inorganic Arsenic µg/g
80
100
g/g
(Cre
atin
in
40
60
ary
Ars
enic
µg
0
20
Urin
a
( h l h h / )(In the 23 samples with more than 15 µg/g creatinine)
Comparison to Other Arsenic Biomonitoring StudiesStudy and Population (Sample size)
Urine Sample
Dates Geometric Mean Total Arsenic
(µg/g creatinine)
Geometric MeanTotal Arsenic
(µg/ L)
Range
MDH Children’s Arsenic Study (N=65) Two July-Sept 13.5 (11.4-15.9) 14.2 (11.5-17.5) 5.6--191.3 µg/gChildren, age 3-10 years, residing in S.
Minneapolis neighborhoodMorning
voids2008 3.4--383.6 µg/L
Smiley’s Clinic in Minneapolis (N=75)Children, age 3-11 years, residing in
Metro area attending clinic
Spotsample
Nov. 2007-Nov. 2008
NA 20.4 (17.5-23.9) 0.8--140.1 µg/L
g
Middleport, New York, Study7 (N=142)Children, Age 2-13 years, residing in
Middleport near an arsenic pesticide facility
Two Morning
voids
August-Sept 2003
NA 15.7 (GSD=1.7) 2.1--59.9 µg/L
US NHANES S d 8 (N 290) S t 2003 2004 8 3 (6 6 10 3) 7 1 (5 7 8 8) 0 9 195 7 /US NHANES Study8 (N=290)Children, 6-11 years of age, stratified
national sample in US
Spot sample
2003-2004 8.3 (6.6-10.3) 7.1 (5.7-8.8) 0.9--195.7 µg/g0.4--333.5 µg/L
Anaconda, Montana10 (N=312)Child <6 idi
Two M i
1992-1993 NA 19.1 (GSD=1.9) NAChildren, age <6 years, residing near a
former copper smelter and soil contamination
Morningvoids
Miami-Dade County, FL Study11 (N=11)Children, age 1-6 years, with (7) and
i h (4) CCA d d
Morning void ordi
? NA 13.6 7.2--23.1 µg/L
without (4) CCA-treated wood playground sets
diaper
Urinary Arsenic Levels vs. l lSoil Arsenic Levels
•200
ted)
•
140
160
180
atin
ine-
corr
ect
80
100
120
ic µ
g/g
(Cre
at
•
••
40
60
80
rinar
y A
rsen
i
••
••
••••••••
•• •••
•••• •••••••••••••••••
••• •••
•••
•••••••
• •••••
0
20
0 100 200 300 400 500 600
Tota
l Ur
Average Soil Arsenic Concentration - ppm
ConclusionsConclusions
• For most children, levels of arsenic found in the urine ,were below levels of health concern. Exposures in this community are comparable to exposures found in similar studies in other communitiessimilar studies in other communities.
• For a few children, elevated levels were found, butFor a few children, elevated levels were found, but speciation showed it was organic arsenic and likely came from foods.
• No relationship was found between levels in the soil and levels in the urineand levels in the urine.
LimitationsLimitations
• Small sample size limits our ability to compareSmall sample size limits our ability to compare to other groups
• Short half‐lifeShort half life• Soil data collected years prior to biomonitoringbiomonitoring
• Soil data do not describe child’s play activities nor exposure to soilnor exposure to soil
• Biomonitoring not able to identify specific sources of exposuresources of exposure
Lake Superior Mercury in Newborns ProjectLake Superior Mercury in Newborns Project
• Funded by U S EPA Great• Funded by U.S. EPA Great Lakes National Program with support from EHTBwith support from EHTB
• Characterize exposure i l ti fin a population of newborns in the Lake S i B iSuperior Basin
• Assess a novel lab method that uses newborn blood spots for mercury biomonitoringblood spots for mercury biomonitoring
MethodsMethods
• Newborns from U S portion of LS Basin (MNNewborns from U.S. portion of LS Basin (MN, WI, MI) born 2008‐2010 (n=1465, 1126 in MN)
• Used residual dried blood spot punches• Used residual dried blood spot punches from Newborn Screening Programs
• Informed consent from MN participants• Specimens anonymized; limited demographic p y ; g pdata available on mother
Mercury AnalysisMercury Analysis
• Performed by MDH Public Health LaboratoryPerformed by MDH Public Health Laboratory• Total mercury measured in two 3‐mm punches from filter paper containing dried bloodfrom filter paper containing dried blood – Used ICP‐MSF f d i d– Form of mercury not determined
• MDL = 0.7µg/l
3 0
3.5
Summer Fall Winter Spring
2.5
3.0
on (u
g/L)
1.5
2.0
M Con
centratio
0.5
1.0Hg GM
0.0
Overall Population Minnesota
For More InformationFor More Information
• MDH Fish Consumption GuidelinesMDH Fish Consumption Guidelines http://www.health.state.mn.us/fish
• Mercury Levels in Blood from Newborns in the L k S i B i S dLake Superior Basin Study http://www.health.state.mn.us/divs/eh/hazard / i / di / b h l h ldous/topics/studies/newbornhglsp.html
AcknowledgmentsAcknowledgments• MDH
– EH: Pat McCann, Carl Herbrandson, Rita Messing– Newborn Screening: Carrie Wolf, Beth‐Ann Bloom, Matthew Zerbyy
– PHL: Betsy Edhlund, Jeff Brenner, Suzanne Skorich– EHTB: Jessica Nelson
• MI and WI NBS Programs• MI and WI NBS Programs • WI DHS ‐ Henry Anderson• Advice on results interpretation ‐ Philippe Grandjean, p pp j ,Alan Stern, Michael Gochfeld
• Funding provided by U.S. EPA GLNPO and the MDH EHTB ProgramEHTB Program.
EHTB Advisory Panel recommends f llfollow‐up projects to:
1 C l l i d bl d t1. Compare mercury levels in cord blood to mercury in newborn blood spots
2. Measure the sources and extent of mercury exposure in other parts of the state
New project with UM TIDES: The Pregnancy & Newborn Exposure Study
• Obtain paired cord blood & newborn bloodObtain paired cord blood & newborn blood spots from approx. 75 newborns
• Measure mercury lead cadmium• Measure mercury, lead, cadmium• Consider demographic, dietary, smoking risk ffactors
• Compare total mercury in cord v. blood spots, speciate mercury in cord blood
Mercury in women aged 16‐49 in NHANES 1999 2004 d EPA RfD1999‐2004, compared to EPA RfD
Source: Mahaffey, EHP 2009
Mercury biomonitoring in U.S. lpopulations
* Level is the 90th percentile.
Sources: Geer, J Environ Monit 2012; Wells, Env Res 2011; Takser, EHP 2005; Mortensen, NCS pilot project 2011
Successes of the ProgramSuccesses of the Program• New PHL lab capacity for measuring analytes in people– Arsenic (speciated), total mercury lead and cadmiummercury, lead and cadmium
– PFCs, BPA, parabens
• Population recruitment and samplingPopulation recruitment and sampling– Clinic‐based, neighborhoods, letters and phone calls
• Results communication methods • Guidance document • Stakeholder engagement
l• Community involvement
Thoughts on biomonitoring for metalsThoughts on biomonitoring for metals
• Speciation very usefulSpeciation very useful• For many, easier to interpret results, health‐based values availablebased values available
• Ubiquitous exposures, most common in state‐b d bi i ibased biomonitoring
• Lab analysis affordable
Thank youThank you
• The many participants in these projectsThe many participants in these projects• Environmental Health Tracking and Biomonitoring staff: Jean Johnson BarbaraBiomonitoring staff: Jean Johnson, Barbara Scott Murdock, Adrienne Kari, and others
• MDH Fish Consumption Advisory Program: Pat• MDH Fish Consumption Advisory Program: Pat McCann
• MDH Public Health Laboratory: Betsy Edhlund• MDH Public Health Laboratory: Betsy Edhlund• EHTB Advisory Panel
Questions?Questions?
Jessica NelsonEnvironmental Public Health Tracking and
Biomonitoring [email protected]
651‐201‐3610www.health.state.mn.us/biomonitoring
Communicating biomonitoring resultsCommunicating biomonitoring results
3 strategies for comparing results:3 strategies for comparing results:1. Clinical guidelines2 f l i2. Reference population3. Risk assessment