Introduction
We monitor what’s in our air, our water, and even what’s
in our fish.
It’s time to start looking at what’s in our bodies. – California
Body Burden Campaign
Biomonitoring is the direct measurement of environmental
chemicals, their primary metabolites, or their reaction
products (such as DNA-adducts) in people – usually in blood
or urine specimens. Currently, human exposure information
is limited. Reliable and accurate exposure data are required
for studies that examine the relation between exposure and
adverse health effects. Decision makers need information
about which environmental chemicals actually get into people
and at what levels to make decisions about public health
issues that will benefit the American public.(1)
Biomonitoring is a type of research that allows us to measure
the “pollution in people” by analyzing blood,
urine, and breast milk samples for pollutants, synthetic
chemicals, and industrial compounds. The data produced through
biomonitoring can support efforts to improve public health
by indicating trends in chemical exposures, identifying
disproportionately affected and particularly vulnerable
communities, linking environmental exposures and pollution-related
disease, assessing the effectiveness of current regulations,
and setting priorities for legislative and regulatory action.(2)
More than 85,000 synthetic chemicals have been introduced
in the last 50 years for industrial, farming, and other
uses, yet more than 90% of them have not been tested for
their effects on human health. Biomonitoring studies have
detected more than 200 toxic substances in breast milk.(3)
In March 2001, the Centers for Disease Control and Prevention
(CDC) released the first National Report on Human Exposure
to Environmental Chemicals. This first edition of the report
presents 27 levels of environmental chemicals measured in
the United States population, including metals such as lead,
mercury, and uranium; cotinine (a marker of tobacco smoke
exposure); and, organophosphate pesticide metabolites as
well as phthalate metabolites. An increasing amount of research
indicates that many of the kinds of chemicals measured by
the CDC can have an adverse impact on human health. In January
2003, the CDC National Center for Environmental Health issued
the second National Report on Human Exposure to Environmental
Chemicals. The report presents biomonitoring exposure data
for 116 chemicals measured in the United States population,
including 89 additional environmental chemicals, including
polycyclic aromatic hydrocarbons and various pesticides
and herbicides, which were not included in the first report.(4)
The CDC National Center for Health Statistics (NCHS) currently
conducts its biomonitoring program through the National
Health and Nutrition Examination Survey (NHANES). NHANES
is an annual, cross-sectional representative survey designed
to collect information about the health and diet of the
civilian, non- institutionalized population of the United
States. NHANES samples about 5,000 people every year. Extensive
laboratory testing of participants’ body fluids is conducted.
For more information on NHANES’ methodology and results,
please visit www.cdc.gov/nchs/nhanes.htm. Although the NHANES
is a valuable source of information for environmental health,
the study has limitations that include:
- A limited number of chemicals;
- Limited geographic coverage, allowing only national
conclusions to be made from the available data. There
is not enough data concentrated in a geographic area to
make conclusions about environmental exposures on state
or local levels; and
- Lack of translation of science to action. The study
is not associated with ongoing health surveillance that
could link confirmed human exposures to known environmental
hazards.(5)
The CDC awarded $10 million in planning grants to 33 states
over 2 years to start building capacity for biomonitoring.
Implementation is set to begin in October 2003. State programs
include:
- Iowa, Minnesota, North Dakota,
South Dakota, and Wisconsin: A biomonitoring consortium
of 5 Upper Midwest states would use a biomonitoring communication
module within Wisconsin’s Health Alert Network, which
is being integrated into Wisconsin’s Environmental Public
Health Tracking System. The 5 states also intend to share
biomonitoring data and samples on toxicants such as metals
and pesticides.
- Pennsylvania: Pennsylvania’s
biomonitoring planning grant currently funds an epidemiology
research associate in the state’s Bureau of Epidemiology.
This position is responsible for supporting biomonitoring
as well as environmental health tracking and establishing
a working relationship between the two. People living
in the vicinity of coal-burning power plants will be evaluated
and tracked for heavy metal exposure including lead, arsenic,
and mercury.
- Washington: Washington’s
primary tracking project involves enhancing the Washington
Electronic Disease Surveillance System’s electronic hospital
reporting of birth defects, the development of population-based
exposure data – including a state biomonitoring program,
and the enhancement of environmental monitoring and data
analyses of persistent toxicants such as mercury and Polychlorinated
Biphenyls (PCBs).(6)
State Legislative Action
California
SB
689 establishes the Healthy Californians Biomonitoring
Project for breast and cervical cancer research; requires
the Department of Health Services to develop a biomonitoring
pilot program using breast milk as a marker of community
health in a minimum of 3 economically, racially, and geographically
diverse communities throughout the state; adds pilot programs
for other biomonitoring markers; and, imposes an additional
tax on tobacco products to fund the project.
5/29/2003 In Senate Committee on Appropriations: Not heard.
New Hampshire
HB
1229 establishes a commission to study bioaccumulative
toxic chemicals.
Introduced 9/4/2003
Washington
SB
5495 establishes an environmental health tracking system.
1/28/2003 Sent to Senate Committee on Health and Long-Term
Care.
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