Lab Matters Summer 2019 - Page 43

APHL 2019 POSTER ABSTRACTS Water Quality Results: In Arkansas, 14 childcare facilities were identified to use private wells and 50% used chlorinators. Interestingly, 5 facilities had access to public water but had not connected to public water due to the cost. No facilities tested positive for E. coli, but 4 facilities were positive for total coliforms. Several facilities had detectable levels of chloride, nitrate, phosphate, and sulfate, but all levels were below the maximum contaminate level (MCL) set by the Environmental Protection Agency. One facility had naturally occurring fluoride. Five of the facilities had acidic water, which could lead to corrosion of the plumbing. Conclusion: This pilot study was the first of its kind in Arkansas to be an inter-agency study as well as bring several different areas of the Arkansas Department of Health together. Also, this study was the first to investigate well water quality in Arkansas. Although the study was small, the collaborations established have continued and further studies have been planned. Presenter: Katie Seely, Arkansas Public Health Laboratory, Little Rock, AR, katie.seely@arkansas.gov Enhanced Opioid Overdose Surveillance in the US D. Mustaquim, Centers for Disease Control and Prevention The opioid overdose epidemic was declared a national emergency in 2017, following dramatic increases in opioid overdose in several areas of the country. Understanding changing trends in overdoses involving prescription and illicit opioids as quickly as possible is essential to deploying effective public heath interventions to reduce morbidity and mortality. Currently, 32 states and Washington DC are funded to perform enhanced opioid overdose surveillance activities through the Enhanced State Opioid Overdose Surveillance (ESOOS) cooperative agreement. The goals of ESOOS are to: 1. Increase timeliness of non-fatal opioid overdose reporting, 2. Increase timeliness of fatal opioid overdose reporting, and 3. Increase dissemination of data to key stakeholders. Enhanced fatal opioid overdose surveillance is based on the State Unintentional Drug Overdose Reporting System (SUDORS), which leverages the National Violent Death Reporting System (NVDRS). SUDORS often includes detailed toxicology testing results, along with data from death certificates and medical examiner/coroner reports. Laboratory data is a critical element of this system and testing is done by a variety of laboratory types, including public health laboratories. Non-fatal opioid overdose surveillance in the US is based on monitoring of emergency department data for indicators of overdose based on chief complaint and discharge diagnosis data (syndromic surveillance) and also hospital discharge data. This does not include laboratory testing data. Laboratory testing is one way to determine what specific drugs are being used and if and how these drugs evolve over time (e.g., new analogs for substances like fentanyl). Some laboratory data sources are emerging that could potentially fill this gap in surveillance, including public health laboratory surveillance testing and commercial laboratory testing. This poster will explain these components of enhanced national opioid overdose surveillance in more detail. The most recent findings from enhanced surveillance activities will be shared, including recent trends and emerging areas of concern. Laboratory data sources being evaluated to supplement nonfatal opioid overdose surveillance will be highlighted as well as their respective strengths. PublicHealthLabs @APHL APHL.org Presenter: Desiree Mustaquim, Centers for Disease Control and Prevention, Atlanta, GA, dwc6@cdc.gov State Approaches to Participant Recruitment, Sample Collection, Surveying, Results Return and Evaluation in Biomonitoring Investigations L. Parcels and K. Dortch, Centers for Disease Control and Prevention The Centers for Disease Control and Prevention’s (CDC) State Biomonitoring Program aims to increase the capability and capacity of state public health laboratories to conduct high- quality biomonitoring science and assess human environmental exposures in their communities. With financial and technical assistance from CDC’s Division of Laboratory Sciences (DLS), state programs purchase laboratory equipment and supplies, hire and train specialized staff, and conduct fieldwork and data analysis. Awardees under the current cooperative agreement include California, New Hampshire, New Jersey, Massachusetts, Virginia, and the 4 Corners States Biomonitoring Consortium (Utah, Arizona, New Mexico, and Colorado). States face many challenges as they develop and implement biomonitoring approaches, including recruitment and selection of a representative sample, survey design and sample collection, results reporting, data management, and program evaluation. Many address these challenges by leveraging funding resources (i.e., in-kind, state, and federal resources) and developing strategic partnerships to strengthen biomonitoring activities. At the State Biomonitoring Programs Annual Awardee Meeting in Atlanta in November 2018, awardees expressed interest in sharing methods for overcoming the obstacles associated with designing and implementing high-quality biomonitoring studies. This summary aims to assemble states’ approaches to increase awareness of successful strategies and stimulate new efforts for recruitment, sample collection, survey design, results return, and evaluation. Presenter: Linde Parcels, Centers for Disease Control and Prevention, Atlanta, GA, oqj1@cdc.gov Trace Metals Lot Screening of Sample Collection and Storage Devices Used in Biomonitoring Studies C. Ward, R. Williams, N. Hilliard and R. Jones, Centers for Disease Control and Prevention The Centers for Disease Control and Prevention’s Inorganic and Radiation Analytical Toxicology Branch uses inductively coupled plasma mass spectrometry to measure levels of metals such as zinc, copper, selenium, antimony, arsenic, barium, beryllium, cadmium, cesium, chromium, cobalt, iodine, lead, molybdenum, manganese, mercury, nickel, platinum, strontium, thallium, tin, tungsten, and uranium in human clinical specimens. A common assumption is that materials such as needles and cryogenic vials and tubes used in the laboratory are free from contamination; however, that is not necessarily the case especially for metals analysis at population based biomonitoring levels. Lot screening is critical for determining accurate population reference levels of screened metals that tend to be at the very low concentration end of the analytical range in clinical specimens. Our branch has a dedicated lot screening laboratory that uses ICP-MS to detect the absence or presence of metal contaminants Summer 2019 LAB MATTERS 41