karen nunley presentation

BIOMONITORING:BIOMONITORING:A PLAN FOR DELAWAREA PLAN FOR DELAWARE

DELAWARE CANCER CONSORTIUM RETREAT DELAWARE CANCER CONSORTIUM RETREAT

FEBRUARY 15, 2010FEBRUARY 15, 2010

Karen Nunley, M.S.

MULTI-MEDIA EXPOSURE STUDYMULTI-MEDIA EXPOSURE STUDY

IntroductionIntroduction BiomonitoringBiomonitoring

BenefitsBenefits LimitationsLimitations

Delaware’s PlanDelaware’s Plan Discussion / Q & ADiscussion / Q & A

MULTI-MEDIA EXPOSUREMULTI-MEDIA EXPOSURE

MULTI-MEDIA EXPOSUREMULTI-MEDIA EXPOSURE

CHEMICALS ENTER THE BODY CHEMICALS ENTER THE BODY VIA:VIA:

Dermal AbsorptionDermal Absorption

InhalationInhalation

IngestionIngestion

InjectionInjection

MULTI-MEDIA EXPOSUREMULTI-MEDIA EXPOSURE

WHAT IS BIOMONITORING?WHAT IS BIOMONITORING?

Measuring human tissue and bodily fluids Measuring human tissue and bodily fluids for the presence of chemicals or their for the presence of chemicals or their metabolitesmetabolites

WHAT IS BIOMONITORING?WHAT IS BIOMONITORING?

Measuring human tissue and bodily fluids Measuring human tissue and bodily fluids for the presence of chemicals or their for the presence of chemicals or their metabolitesmetabolites

Provides information about the ‘internal’ Provides information about the ‘internal’ dose rather than the ‘external’ dose rather than the ‘external’

concentrationconcentration

EFFECTS DEPEND ON:EFFECTS DEPEND ON:

Exposure routeExposure route

Exposure durationExposure duration

Exposure frequencyExposure frequency

Exposure intensityExposure intensity

HISTORYHISTORY

Used in late 1800s to test workers for Used in late 1800s to test workers for

lead and to monitor salicyluric acid lead and to monitor salicyluric acid levels in people being treated for levels in people being treated for rheumatismrheumatism

Historically used in occupational Historically used in occupational settingssettings

HISTORYHISTORY

In the last few decades, expanded In the last few decades, expanded to measure chemical exposures in to measure chemical exposures in the general populationthe general population

BIOMARKERSBIOMARKERS

ExposureExposure

EffectEffect

SusceptibilitySusceptibility

All substances are poisons; there is none which All substances are poisons; there is none which is not a poison. The right dose differentiates a is not a poison. The right dose differentiates a poison from a remedy (poison from a remedy (Paracelsus, 1567)Paracelsus, 1567)

BENEFITSBENEFITS

LIMITATIONSLIMITATIONS

Only a snapshot of exposureOnly a snapshot of exposure

Exposure Exposure Disease Disease

Cannot reveal exposure sources or Cannot reveal exposure sources or routes routes

Influence of personal behaviors, Influence of personal behaviors, geneticsgenetics

Unknown additive/synergistic effects of Unknown additive/synergistic effects of chemicals chemicals

Ethical issuesEthical issues

DELAWARE’S BIOMONITORING DELAWARE’S BIOMONITORING PLANPLAN

DELAWARE’S BIOMONITORING DELAWARE’S BIOMONITORING PLANPLAN

Pilot three target areasPilot three target areas

Approximately 400 Delawareans ages18 and Approximately 400 Delawareans ages18 and olderolder

Samples collected summer and winter; Samples collected summer and winter; repeat over 2-3 yearsrepeat over 2-3 years

Expand to statewide samplingExpand to statewide sampling

DELAWARE’S BIOMONITORING DELAWARE’S BIOMONITORING PLANPLAN

Testing for variety of substancesTesting for variety of substances Blood, urine, hair samplesBlood, urine, hair samples

Extensive questionnaireExtensive questionnaire

Environmental SamplesEnvironmental Samples Water, air, soil/dustWater, air, soil/dust

DELAWARE’S BIOMONITORING DELAWARE’S BIOMONITORING PLANPLAN

Prospective Study Prospective Study

Archive samples for future testingArchive samples for future testing

Create databaseCreate database

DATABASE FUNCTIONS:DATABASE FUNCTIONS:

Detect which chemicals are present in Detect which chemicals are present in Delawareans, and in what Delawareans, and in what concentrationsconcentrations

Regional exposure varianceRegional exposure variance

Exposure disparitiesExposure disparities

Monitor changes over timeMonitor changes over time

Evaluate Public Health programsEvaluate Public Health programs

FUTURE USES:FUTURE USES:

Enact and evaluate effectiveness of Enact and evaluate effectiveness of exposure reduction strategiesexposure reduction strategies

Support legislationSupport legislation

Provide data to support future Provide data to support future epidemiological studies via linkage to epidemiological studies via linkage to disease and hospitalization recordsdisease and hospitalization records

Decrease uncertainty inherent in Decrease uncertainty inherent in exposure risk assessmentsexposure risk assessments

WILL NOT:WILL NOT:

Sample every DelawareanSample every Delawarean

Provide full exposure history Provide full exposure history

Identify exact exposure source(s) or Identify exact exposure source(s) or disease causationdisease causation

Identify who will or will not develop a Identify who will or will not develop a disease endpointdisease endpoint

Q & AQ & A

THANK YOU!THANK YOU!

Karen Nunley, M.S.