State Public Health Laboratory Biomonitoring Programs: Implementation and Early Accomplishments
Fox, Mary A., Latshaw, Megan, Journal of Environmental Health
Introduction and Background
Biomonitoring is one direct method for measuring human exposure to environmental contaminants (Committee on Human Biomonitoring for Environmental Toxicants, 2006). Just as monitoring contaminants in the ambient environment informed pollution prevention policies over the past decades, biomonitoring serves as a powerful tool to shape environmental public health (Association of Public Health Laboratories [APHL], 2009a). Examples of environmental health policy successes supported by biomonitoring include declines in blood lead levels following the ban of leaded gasoline and declines in cotinine levels in nonsmokers following a smoking ban (Annest et al., 1983; Centers for Disease Control and Prevention [CDC], 2007). Biomonitoring is often used to calm fears related to potential exposures (Teeguarden et al., 2011) or to effectively target limited environmental remediation funding (APHL, 2009b).
Biomonitoring remains indispensible as the field of environmental public health advances toward answering emerging questions concerning: exposures across the lifespan (Woodruff, Zota, & Schwartz, 2011); health impacts of chemical mixtures (Payne-Sturges, Cohen, Castorina, Axelrad, & Woodruff, 2009); and assessment of cumulative risks including multiple chemicals in addition to population variability and susceptibility (Ryan, Burke, Cohen Hubal, Cura, & McKone, 2007).
The environmental health profile of the National Health and Nutrition Examination Survey (NHANES) now includes more than 200 chemicals and the resulting data establish population-based reference ranges for each chemical as well as fostering a body of descriptive and analytical epidemiological research (CDC, 2009; Crinnion, 2010; Hightower, O'Hare, & Hernandez, 2006; Navas-Acien et al., 2009). While NHANES is an essential national resource, it has important limitations: little information exists on sources of exposure, and it provides no data at the state and local levels. Lacking data on location and exposure sources, NHANES cannot inform exposure reduction actions that might be taken by state or local health officials.
The Association of Public Health Laboratories (APHL) developed the National Biomonitoring Plan (NBP) to fill this information gap by improving state and local capacity for biomonitoring (APHL, 2009a). The goal entails a coordinated national approach to addressing public health issues related to chemical exposures: one which will enable benchmarking and comparisons across studies.
In addition to supporting APHL, the Centers for Disease Control and Prevention (CDC) have supported the development of state capacity for biomonitoring through a cooperative agreement program, initially awarded to three states: California, New York, and Washington. The cooperative agreements were initiated in 2009 and will provide up to five years of funding with an annual renewal. The three state public health laboratory-based pilot projects are working to understand state and local exposure conditions; take action to reduce those exposures; and lead the way toward the NBP. Each program is briefly described below
* Biomonitoring California is lead by the California Department of Public Health (CDPH) working jointly with the Office of Environmental Health and Hazard Assessment and the Department of Toxic Substance Control (DTSC) in California's Environmental Protection Agency. Two laboratories are affiliated with the biomonitoring program: the CDPH Environmental Health Laboratory and the DTSC Environmental Chemistry Laboratory. Biomonitoring California operates under a legislative mandate.
* The New York State (NYS) biomonitoring program is part of the Wadsworth Center, the NYS Department of Health's (NYS-DOH's) public health laboratory. The biomonitoring program collaborates with the New York City Department of Health and Mental Hygiene and NYSDOH Center for Environmental Health. …