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In biochemistry, biomonitoring is the measurement of the body burden of toxic chemical compounds, elements, or their metabolites, in biological substances.[1][2], many of which can have psychological effects. Often, these measurements are done in blood and urine.[3]

In 2001, the U.S. Centers for Disease Control and Prevention began to publish its biennial National Report on Human Exposure to Environmental Chemicals, which reports a statistically representative sample of the U.S. population.[4] The Environmental Working Group has also conducted biomonitoring studies.[5]

OverviewEdit

Historically, public health regulations have been based on theoretical risk calculations according to known levels of chemical substances in air, water, soil, food, other consumer products and other sources of potential exposure. Human biomonitoring offers the opportunity to analyze the actual internal levels of bodily substances from all potential routes of exposure at one time, which may contribute to improving risk assessments.[6] Scientific advancements have made it possible to detect a greater number of chemical substances in smaller concentrations in the body, with some chemicals detectable at levels as low as parts per trillion.[7] A single biomonitoring measurement is only one snapshot in time and may not accurately reflect the level of exposure over longer periods.[8]

In 2006 the U.S. National Research Council published a report, Human Biomonitoring for Environmental Chemicals. The report recognized the value of biomonitoring for better understanding exposure to environmental chemicals, and included several findings and recommendations to improve the utility of biomonitoring data for health risk assessment. In summary, the report called for more rigorous health-based criteria for selecting chemicals to include in biomonitoring studies; the development of tools and techniques to improve risk-based interpretation and communication of biomonitoring data; integration of biomonitoring into exposure assessment and epidemiological research; and exploration of bioethical issues around biomonitoring, including informed consent, confidentiality of results, and others.[9]

The issue of exposure to environmental chemicals has received attention as a result of televised reports by Bill Moyers for PBS and Anderson Cooper for CNN's "Planet in Peril" series.[10] The book Our Stolen Future, with a foreward by former Vice President Al Gore, also raised awareness by focusing on endocrine disruption.

SurveysEdit

  • In the United States, the CDC first tested samples from the general population for lead and a few pesticides in 1976.[11] In the late 1990s, the National Health and Nutrition Examination Survey (NHANES) program had a major expansion.[11]
  • Some U.S. states have received federal support[12] and have established biomonitoring programs. In 2001, the CDC awarded planning grants to 33 states to assist in capacity building for expanding biomonitoring.[13] The California Environmental Contaminant Biomonitoring Program (CECBP), is administered by the California Department of Public Health, and was established by law in 2006.[14] Minnesota's Biomonitoring Pilot Program was established by law in 2007 and is run by the Minnesota Department of Health.[15]
  • The Environmental Working Group's (EWG) Human Toxome Project and the Canadian group Environmental Defence's Toxic Nation project have directed studies.[5][16]
  • In Germany, the German Environmental Survey (GerES) has been active since 1985,[17][3] and in 1992 the Human Biomonitoring Commission of the German Federal Environment Agency was established.[18]
  • In Canada, Statistics Canada administers the Canadian Health Measures Survey, which includes biomonitoring for environmental chemicals.[19] Health Canada administers a program called Mother-Infant Research on Environmental Chemicals, which focuses on 2,000 pregnant women and their infants.[20]

National Report on Human Exposure to Environmental ChemicalsEdit

The CDC's Division of Laboratory Sciences within the National Center for Environmental Health has developed a National Biomonitoring Program, and publishes the biennial National Report on Human Exposure to Environmental Chemicals. As the selection of chemicals is controversial, the CDC has identified influential criteria:[21]

  • Evidence of exposure in a U.S. population
  • The presence and significance of health effects after a given level of exposure
  • Desire to track public health initiatives to reduce exposure to a given agent
  • Existing method for accurately measuring biologically relevant concentrations of the chemical
  • Sufficient tissue specimens, in particular, blood and/or urine samples
  • Cost-effectiveness.

CDC has also established three criteria for removing chemicals from future editions of the National Report:

  • A new replacement chemical (i.e., a metabolite or other chemical) is more representative of exposure than the chemical currently measured, or
  • If after three survey periods, detection rates for all chemicals within a method-related group are less than 5 percent for all population subgroups (i.e., two sexes, three race/ethnicity groups, and the age groups used in the National Report), or
  • If after three survey periods, levels of chemicals within a method-related group are unchanged or declining in all demographic subgroups documented in the National Report.[22]

National Children's StudyEdit

In collaboration with the National Institute of Child Health and Development (NICHD), National Institute of Environmental Health Sciences and U.S. Environmental Protection Agency, the CDC's Environmental Health Laboratory has announced it will play a key role in the biomonitoring of the ongoing National Children's Study, which plans to follow 100,000 children across the United States from birth until age 21. The study was authorized as part of the Children's Health Act of 2000 and is the largest effort undertaken to address the effects of social, economic and environmental factors on a child's health.[23]

Methods and chemicalsEdit

Chemicals and their metabolites can be detected in a variety of biological substances such as blood, urine, hair, semen, breast milk, or saliva.[24] Breast milk is a favored matrix (substance) to measure lipophilic (fat-loving) persistent, bioaccumulative, and toxic (PBT) compounds during lactation; this exposure route is dominant for breastfeeding children.[25] A lipophilic compound might also be detected in blood, while a hydrophilic (water-loving) compound might be detected in urine. Analytical methods used by the CDC include isotope dilution mass spectrometry, inductively coupled plasma mass spectrometry, or graphite furnace atomic absorption spectrometry.[26]

Some of the detected chemicals include:

InterpretationEdit

The presence of an environmental chemical in the body does not necessarily indicate harm. A chemical's toxicity is determined by a range of factors, including its concentration and a person's individual susceptibility. Small amounts of a chemical may produce no health effects, whereas larger amounts may have an impact.[26]

The presence of chemicals in the body has advanced more rapidly than the ability to interpret the potential health consequences of exposure.[27] Scientific evaluations of health risks from chemicals typically involve toxicity studies in laboratory animals and subsequent extrapolation to humans. Such studies have been used to establish regulatory exposure standards, but their relation to levels measured in biomonitoring studies is not always known.

CommunicationEdit

Participants in biomonitoring studies typically want to know whether the chemical compositions measured in their bodies indicate that they are healthy (or not); however, biomonitoring studies are not designed to answer this particular question. While biomonitoring is useful for assessing exposure, without other information, it is not alone useful in determining a person's health or likelihood of developing ill effects.[8][28] According to the National Research Council, accurate communication of results is essential for the proper use of biomonitoring surveys, but states "there is no accepted standard for good biomonitoring communications".[27]

Standards and guidelines that health professionals can use to communicate biomonitoring information are still evolving. Foster and Agzarian write, "Because of the lack of clear reference ranges and standards, however, it is unlikely that providing study subjects with their individual exposure results in the absence of information about the health significance of the results would create anxiety and anger among study subjects."[8] An expert panel on Biomonitoring Equivalents has published guidelines for communicating information to the general public and health care providers.[29]

Dr. Charles McKay of the Connecticut Poison Control Center provides a perspective to assist medical toxicologists with understanding human biomonitoring data[30] is interviewed in a video titled "A Medical Doctor's Perspective on Biomonitoring", which is focused on helping the general public better understand biomonitoring.[31]

Boston Consensus ProjectEdit

In 2007, the Boston University School of Public Health organized a panel, the Boston Consensus Conference on Biomonitoring, for the purpose of educating residents about the scientific, legal and ethical issues of biomonitoring, and coming to an understanding of the lay panel's priorities and concerns related to measuring human exposure to environmental chemicals. The conference produced a report for public health policy makers and scientists who deal with or study the issues.[32]

See alsoEdit

ReferencesEdit

  1. Third National Report on Human Exposure to Environmental Chemicals. (PDF) Centers for Disease Control and Prevention – National Center for Environmental Health. URL accessed on 9 August 2009.
  2. What is Biomonitoring?. (PDF) American Chemistry Council. URL accessed on 11 January 2009.
  3. 3.0 3.1 Angerer J, Ewers U, Wilhelm M (May 2007). Human biomonitoring: state of the art. Int. J. Hyg. Environ. Health 210 (3-4): 201–28.
  4. About the Program. cdc.gov. Centers for Disease Control. URL accessed on 25 May 2009.
  5. 5.0 5.1 About the Human Toxome Project. Human Toxome Project. Environmental Working Group. URL accessed on 30 September 2009.
  6. Juberg, Daland R.; Bus, James; Katz, Diane S. (February 2008), "The Opportunities and Limitations of Biomonitoring", Policy Brief 
  7. What is Biomonitoring?. (PDF) American Chemistry Council. URL accessed on 11 January 2009.
  8. 8.0 8.1 8.2 Foster, Warren G.; Agzarian, John (2007), "Reporting results of biomonitoring studies", Analytical and Bioanalytical Chemistry 387: 137-140, doi:10.1007/s00216-006-0822-6 
  9. Statement on Biomonitoring. acs.org. URL accessed on 23 July 2009.
  10. Planet in Peril. CNN.com. CNN. URL accessed on 13 December 2009.
  11. 11.0 11.1 Stokstad E (June 2004). Biomonitoring: Pollution gets personal. Science 304 (5679): 1892–4.
  12. State Grant Activities. Centers for Disease Control and Prevention. URL accessed on 30 September 2009.
  13. National Research Council (2006), Human Biomonitoring for Environmental Chemicals, National Academies Press, ISBN 0-309-10272-3, http://www.nap.edu/catalog.php?record_id=11700 
  14. California Biomonitoring Program. CA.gov. URL accessed on 23 July 2009.
  15. Environmental Public Health Tracking & Biomonitoring. Minnesota Department of Health. URL accessed on 23 July 2009.
  16. Toxic Nation Studies. Toxic Nation. Environmental Defence. URL accessed on 30 September 2009.
  17. Schulz C, Conrad A, Becker K, Kolossa-Gehring M, Seiwert M, Seifert B (May 2007). Twenty years of the German Environmental Survey (GerES): human biomonitoring – temporal and spatial (West Germany/East Germany) differences in population exposure. Int. J. Hyg. Environ. Health 210 (3-4): 271–97.
  18. Schulz C, Angerer J, Ewers U, Kolossa-Gehring M (May 2007). The German Human Biomonitoring Commission. Int. J. Hyg. Environ. Health 210 (3-4): 373–82.
  19. Canadian Health Measures Survey. statcan.gc.ca. Statistics Canada. URL accessed on 2 October 2009.
  20. Maternal-Infant Research on Environmental Chemicals (The MIREC Study). hc-sc.gc.ca. Health Canada. URL accessed on 2 October 2009.
  21. Paustenbach D, Galbraith D (August 2006). Biomonitoring and biomarkers: exposure assessment will never be the same. Environ. Health Perspect. 114 (8): 1143–9.
  22. "Public Comments and Revised Criteria for Removing Chemicals Future Editions of CDC's National Report on Human Exposure Environmental Chemicals", Federal Register 73 (61): 16688, 28 March 2008, http://www.cdc.gov/exposurereport/pdf/fr_032808.pdf, retrieved on 10 November 2009 
  23. National Children's Study. cdc.gov. URL accessed on 23 July 2009.
  24. Sexton, S. (January–February 2004). Human Biomonitoring of Environmental Chemicals. American Scientist 92 (1): 38–45.
  25. Smolders R, Schramm KW, Nickmilder M, Schoeters G (2009). Applicability of non-invasively collected matrices for human biomonitoring. Environmental Health 8 (8).
  26. 26.0 26.1 "Interpreting the Data", Third National Report on Human Exposure to Environmental Chemicals, Atlanta, GA: Centers for Disease Control and Prevention, 2007, http://www.cdc.gov/exposurereport/report.htm 
  27. 27.0 27.1 Human Biomonitoring for Environmental Chemicals, National Research Council, 2008, http://www.nao.edu/catalog/11700.html 
  28. "Interpreting the Data". Third National Report on Human Exposure to Environmental Chemicals. Centers for Disease Control and Prevention. URL accessed on 30 September 2009.
  29. LaKind, J.; Aylward, L.L.; Brunk, C.; DeZio, S.; Dourson, M.; Goldstein, D.A.; Kilpatrick, M.E.; Krewski, D.; et al. (2008), "Guidelines for the communication of Biomonitoring Equivalents: Report from the Biomonitoring Equivalents Expert Workshop", Regulatory Toxicology and Pharmacology 51 (3, supp 1): S16-26, doi:10.1016/j.yrtph.2008.05.007 
  30. McKay, Jr., C.A.; Holland, M.G.; Nelson, L.S. (2003), "A Call to Arms for Medical Toxicologists: The dose, not the detection, makes the poison", International Journal of Medical Toxicology 6(1): 1 
  31. John Heinze, Ph.D.. Science Advisory Council member Dr. Charles McKay provides a medical doctor's perspective on biomonitoring. Biomonitoringinfo.org. Biomonitoring Info. URL accessed on 30 September 2009.
  32. Consensus Statement on Human Biomonitoring. Measuring Chemicals in Poeople -- What Would You Say?. Boston University School of Public Health. URL accessed on 23 July 2009.

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