Kansas Lab Makes Enormous Strides in Lead Screening

Did you know that this week is National Lead Poisoning Prevention Week?  And did you know that elevated lead levels in children can cause decreased/delayed learning and behavioral problems?  According to CDC, 250,000 US children aged 1-5 years have blood lead levels greater than 10 micrograms of lead per deciliter of blood, the level at which CDC recommends public health actions be initiated.  Public health laboratories around the country are testing their state’s children to ensure that necessary actions are taken.

In an effort to test more children, the Kansas Health and Environmental Laboratories began a new project. Their original goal in 2002 was to screen every child at 12 and 24 months of age, but they needed a less traumatic way to collect blood from these toddlers. Using the newborn screening program as a guide, the Kansas lab staff developed a similar method to use filter paper to collect blood spots and analyze them for lead. The filter paper used for the newborn screening program is the same filter paper used for blood lead screening. Other similarities include the ease of specimen collection, transportation and training. The lab developed a new method to test for lead from the dried blood spots and developed a specimen submission form that was easy for nursing staff and others to use in the field.

In 2002 prior to starting the filter paper blood spot screening, the Kansas Public Health Lab analyzed around 3,500 blood lead specimens per year. In 2004 with the new screening in place, the lab increased screening to 14,000 specimens per year.  This is an enormous increase and a huge step forward in helping to identify children at risk of lead poisoning and preventing the harmful effects that lead can cause in children.

Computer Models Can’t Replace Real Testing

By Jennifer Beck Pierson, MPH, Senior Specialist, Environmental Health, APHL

Scientists in Europe are working on a new computer model that would reportedly predict chemical risk. While Europe is years ahead of the US in toxicity research and banning of harmful chemicals, many people remain skeptical about computer models. Historically, models used to predict risk are fraught with errors and unreliable -- characteristics that can only help manufacturers to win approval of new chemicals.

If this new computer model can actually identify hazards in chemicals before they are brought to market, it will provide a much needed solution to an ongoing problem. Animal testing is expensive, time consuming and politically sensitive. Chemical manufacturers do not want to jump through hoops to bring their product to market. 

Unlike Europe, which operates under the precautionary principle, in the US there are few barriers to new chemicals entering the market. US regulations under the Toxic Substances Act (TSCA) are weak at best. In fact, only three chemicals have been regulated under TSCA since it passed in 1976, because of a loophole in the statute relating to unreasonable risk. Even asbestos, a known carcinogen linked to tens of thousands of cases of mesothelioma, has yet to be banned outright.

The proposed computer model may sound like a magic bullet, but it can’t replace testing conducted by experienced toxicologists and other laboratory professionals. What we need is more toxicity research to better understand the effects of chemicals on people.

Notes from the President: Strengthening the Relationship Between APHL and EPA

By Dr. Patrick Luedtke, M.D.; President, APHL; Director, Unified State Laboratories, Utah Department of Health

I just returned from a wonderful meeting at the Environmental Protection Agency (EPA) national office in Washington DC with the EPA Deputy Administrator Bob Perciasepe and Phil Metzger (Advisor to the Deputy Administrator). In attendance from APHL were Scott Becker (Executive Director), Peter Kyriacopoulos (Senior Director Public Policy), and Megan Latshaw (Environmental Health Program Director). 

The core discussion revolved around the potential benefits of an EPA Laboratory Office that would serve to coordinate all environmental laboratory-based policy, practice, and program efforts in a cross cutting fashion. Additionally, this office would serve as a single point of contact for laboratory-based communication efforts to external partners. 

A secondary discussion involved the need for a single data standard across EPA. This discussion included sharing knowledge of the challenges governmental environmental laboratories face concerning multiple data systems, as well as the major benefits that would accrue to our national environmental laboratory system should such a single data standard be adopted. 

Most importantly, our conversation enabled us to describe the interaction between State and local governmental environmental laboratories and EPA, and share a vision on how that interaction can evolve and lead to even better health outcomes. All in all, it was deeply gratifying at a professional and personal level to engage in such a collegial and congenial dialogue – a dialogue that I am excited about continuing as the relationship between APHL and EPA matures and strengthens.

Celebrating Earth Day and Lab Week

Happy Earth Day! This year marks the 40th anniversary of this celebration, a day designed to inspire awareness and appreciation for the Earth's environment. While we have come a long way in improving our environment – no more rivers so contaminated that they regularly are consumed in flame, for example – we still have a long way to go, as evidenced by recent findings of contaminants in dog food, baby bottles, and children’s toys.

Did you know that laboratories are vital to protecting us from harmful contaminants in our environment?

Public health laboratories measure contaminants once they get into our bodies, while environmental laboratories measure contaminants in the environment itself (in the air, water or soil).

To better illustrate the importance of the lab’s role in protecting us from environmental contamination, here is a fictional but realistic scenario:

A group of six young men, all apparently friends, arrive at a local emergency room with similar symptoms: nausea, vomiting, headache, fatigue and weakness. The ER immediately takes blood and urine specimens, sending them to the hospital labs for screening while simultaneously contacting the state Poison Control Center for advice.

Tests indicate cell and tissue decomposition and the Poison Control Center suspects radiation sickness. They recommend calling the state public health lab for guidance. Meanwhile, all of the patients and medical staff who came into contact with these men (receptionists, nurses, and physicians) enter quarantine. The men’s clothing is secured.

The public health lab contacts the local FBI field office, which immediately sends agents, while the Department of Defense’s Civil Support Team begins processing the men’s townhome. A suspicious white powder is found along with documentation on a laptop linking the men to a recent theft totaling over $75M in radiopharmaceuticals. Following confirmation of radioactivity, the scene is evacuated and cordoned off.

Meanwhile, the FBI locates a storage unit rented by one of the men under an assumed name. Upon search of the unit they find more of the white powdery substance as well as containers of paint remover, concentrated sulfuric acid and hydrogen peroxide. In addition, the unit contains laboratory equipment (glassware, distillers, mixers, an ice bath and filters).

Ultimately, the white powder is determined to be Triacetone Triperoxide (TATP), a powerful, highly unstable homemade explosive. Apparently, the men were trying to build a dirty bomb and were exposed to the radioactive pharmaceutical they had stolen.

People who came into contact with these men remain concerned about their potential exposure, so the state public health lab tests their urine. The results reassure the medical staff and the men’s neighbors that they need not worry. The state environmental laboratory tests soil and water samples from around the storage unit and the men’s townhome; much to local policymakers’ relief the results show no reason for concern.*

Thanks to the coordinated response between the hospital, the Poison Control Center, the Civil Support Team, the public health laboratory, the environmental laboratory and the FBI, the terrorist plot was foiled. Public health and safety were protected!

* Note that there is no national program for radioanalytical laboratory preparedness and response. Some states are better able to test for radioactivity than others, some not at all.

For more information on environmental health and laboratories see www.aphl.org/eh

For more information on Earth Day see:

• Top Ten Actions Individuals, Organizations, and Businesses can Take in Reducing Their Contribution to Global Warming
• Commit to taking action or sign up for daily green tips