Karen Nunley Presentation

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2nd Annual DCC Retreat

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Karen Nunley Presentation

  1. 1. BIOMONITORING: A PLAN FOR DELAWARE DELAWARE CANCER CONSORTIUM RETREAT FEBRUARY 15, 2010 Karen Nunley, M.S.
  2. 2. MULTI-MEDIA EXPOSURE STUDY <ul><li>Introduction </li></ul><ul><li>Biomonitoring </li></ul><ul><ul><li>Benefits </li></ul></ul><ul><ul><li>Limitations </li></ul></ul><ul><li>Delaware’s Plan </li></ul><ul><li>Discussion / Q & A </li></ul>
  3. 3. MULTI-MEDIA EXPOSURE
  4. 4. MULTI-MEDIA EXPOSURE
  5. 5. <ul><li>CHEMICALS ENTER THE BODY VIA: </li></ul><ul><ul><li>Dermal Absorption </li></ul></ul><ul><ul><li>Inhalation </li></ul></ul><ul><ul><li>Ingestion </li></ul></ul><ul><ul><li>Injection </li></ul></ul>
  6. 6. MULTI-MEDIA EXPOSURE
  7. 7. WHAT IS BIOMONITORING? <ul><li>Measuring human tissue and bodily fluids for the presence of chemicals or their metabolites </li></ul>
  8. 8. WHAT IS BIOMONITORING? <ul><li>Measuring human tissue and bodily fluids for the presence of chemicals or their metabolites </li></ul><ul><li>Provides information about the ‘internal’ dose rather than the ‘external’ concentration </li></ul>
  9. 10. EFFECTS DEPEND ON: <ul><li>Exposure route </li></ul><ul><li>Exposure duration </li></ul><ul><li>Exposure frequency </li></ul><ul><li>Exposure intensity </li></ul>
  10. 11. HISTORY <ul><li>Used in late 1800s to test workers for lead and to monitor salicyluric acid levels in people being treated for rheumatism </li></ul><ul><li>Historically used in occupational settings </li></ul>
  11. 12. HISTORY <ul><li>In the last few decades, expanded to measure chemical exposures in the general population </li></ul>
  12. 13. BIOMARKERS <ul><li>Exposure </li></ul><ul><li>Effect </li></ul><ul><li>Susceptibility </li></ul>
  13. 14. <ul><li>All substances are poisons; there is none which is not a poison. The right dose differentiates a poison from a remedy ( Paracelsus, 1567) </li></ul>
  14. 16. BENEFITS
  15. 23. LIMITATIONS
  16. 24. <ul><li>Only a snapshot of exposure </li></ul><ul><li>Exposure  Disease </li></ul><ul><li>Cannot reveal exposure sources or routes </li></ul><ul><li>Influence of personal behaviors, genetics </li></ul><ul><li>Unknown additive/synergistic effects of chemicals </li></ul><ul><li>Ethical issues </li></ul>
  17. 25. DELAWARE’S BIOMONITORING PLAN
  18. 26. DELAWARE’S BIOMONITORING PLAN <ul><li>Pilot three target areas </li></ul><ul><li>Approximately 400 Delawareans ages18 and older </li></ul><ul><li>Samples collected summer and winter; repeat over 2-3 years </li></ul><ul><li>Expand to statewide sampling </li></ul>
  19. 27. DELAWARE’S BIOMONITORING PLAN <ul><li>Testing for variety of substances </li></ul><ul><ul><li>Blood, urine, hair samples </li></ul></ul><ul><li>Extensive questionnaire </li></ul><ul><li>Environmental Samples </li></ul><ul><ul><li>Water, air, soil/dust </li></ul></ul>
  20. 28. DELAWARE’S BIOMONITORING PLAN <ul><li>Prospective Study </li></ul><ul><li>Archive samples for future testing </li></ul><ul><li>Create database </li></ul>
  21. 29. DATABASE FUNCTIONS: <ul><li>Detect which chemicals are present in Delawareans, and in what concentrations </li></ul><ul><li>Regional exposure variance </li></ul><ul><li>Exposure disparities </li></ul><ul><li>Monitor changes over time </li></ul><ul><li>Evaluate Public Health programs </li></ul>
  22. 30. FUTURE USES: <ul><li>Enact and evaluate effectiveness of exposure reduction strategies </li></ul><ul><li>Support legislation </li></ul><ul><li>Provide data to support future epidemiological studies via linkage to disease and hospitalization records </li></ul><ul><li>Decrease uncertainty inherent in exposure risk assessments </li></ul>
  23. 31. WILL NOT: <ul><ul><li>Sample every Delawarean </li></ul></ul><ul><ul><li>Provide full exposure history </li></ul></ul><ul><ul><li>Identify exact exposure source(s) or disease causation </li></ul></ul><ul><ul><li>Identify who will or will not develop a disease endpoint </li></ul></ul>
  24. 32. Q & A
  25. 33. THANK YOU! Karen Nunley, M.S.

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