Lab Matters Fall 2017 | Page 4

president ’ s message

When I first heard about biomonitoring early in my public health career , I was intrigued and amazed by the scientific brilliance of the concept .

It was not simply the ability of modern instruments to detect and accurately quantify the ultra-low concentration of environmental chemicals in blood or urine , remarkable as it was for any scientist . I was even more impressed by a new integrative concept — the ability to obtain the totality of environmental exposures ( or more accurately “ body burden ”) for an individual with a single test . Instead of having to come up with separate , difficult measurements of a given contaminant in air , water and food , and use complex modeling algorithms , with a ton of assumption , and end up with an approximation of what a person was exposed to , we can now tell everyone how much of a chemical they absorbed by measuring it directly in their body fluids !

While the full potential of this concept is still to be realized — and , as it always is in science , not quite as simple as it sounds — we are now closer than ever before to bringing biomonitoring to all states .

The diagnosis of lead poisoning by determining the blood lead concentration is the most widely known example of biomonitoring . Perhaps because it has been in the public health field for so many decades , it has become a stand-alone program , seemingly without a clear connection to the rest of the biomonitoring efforts . It has become automatic in many states with universal screening requirements to test children for lead and compare their level to CDC-defined reference levels without necessarily thinking this is biomonitoring . It ’ s a blood test , one of many a doctor can order , and you get it from any medical lab . Surprisingly , it is the “ emerging ” contaminants with undefined reference levels and unclear health effects that make people want to know whether these chemicals might be present in their bodies .

In the last few years , there have been several instances of states dealing with the problem of drinking water wells contaminated with per- and polyfluoroalkyl substances ( PFAS ). These substances are normally not monitored for in drinking water , and the discovery of a significant PFAS contamination in a community usually comes as a shock to residents , and sometimes to government officials as well . The response to such recent events in New Hampshire , New York and Vermont involved biomonitoring tests provided by federal and / or state laboratories , with a great deal of anxiety and learning involved . Given the relative novelty of the approach , I was very surprised when during the discussion of planned surveillance of drinking water wells for PFAS in Rhode Island , it was one of the environmental agency officials who said “ Are you going to have to do these blood tests , too ”? While the tone of his question left no doubt about what he was thinking of these “ blood tests ”— and his hope it would not go that far — the fact that he knew this possibility existed and how it could be used left me smiling .

Over the past decade , APHL ’ s Environmental Health Committee spent a lot of effort convincing state environmental health directors and other stakeholders that biomonitoring is a core function of public health . Position statements and fact sheets were written and distributed , but not much was happening in states without direct access to biomonitoring funds . Thanks to several years of federal funding given to states for biomonitoring efforts , more and more public health officials became conversant in this field .

This year , we have another milestone : the National Biomonitoring Network is being launched , helping link laboratories with interest in biomonitoring increase their capabilities to perform sound biomonitoring measurements and conduct scientifically valid biomonitoring studies . You can read about the Network elsewhere in this issue . n

Over the past decade , APHL ’ s Environmental Health Committee spent a lot of effort convincing state environmental health directors and other stakeholders that biomonitoring is a core function of public health .”

– Ewa King , PhD