Biomonitoring ….a dialogue

1. Biomonitoring ….a dialogue EnviroCancer Connections-LDL February 14, 2005 Discussion Leader: Suzanne Snedeker - BCERF

2. BiomonitoringOutline and discussion Q’s • What is biomonitoring? • Why has there been an increase in interest in the scientific, public health, and advocacy communities? • How does biomonitoring fit into emerging “public health tracking-programs” and research studies? • What are strengths and limitations of biomonitoring in public health tracking?

3. BiomonitoringOutline and discussion Q’s • What are your questions about these approaches? • How will these approaches address questions you would like to see answered? • What are ways the cancer survivor community can communicate its priorities at the state and federal level?

4. BiomonitoringWhat is it? Center for Disease Control’s definition • Biomonitoring – is the direct measurement of environmental chemicals or metabolites in human specimens (such as blood or urine) • Measures “internal dose” rather than “external” sources of exposure Note: Human specimens can include: • Blood (whole or serum), lymphocytes (white blood cells), urine, saliva, adipose tissue, breast milk, toe nails, hair, and exhaled breath

5. Biomonitoring Why the rapid rise in interest? • 1967-1990 National Human Monitoring Program • Included monitoring organochlorine chemicals in human adipose tissue (National Human Adipose Tissue Survey) • From 1990 on, limited biomonitoring by the CDC • Exposures to Superfund chemicals • Trends in blood lead, solvents, and pesticide exposure August 1995, Vol. 103, Suppl. 3 • Environmental Health Perspectives • Special Issue on: Human Tissue Monitoring & Specimen Banking <http://ehp.niehs.nih.gov/members/Suppl-3/goldman-full.html>

6. Biomonitoring Why the rapid rise of interest? October 2004, Vol. 12, issue no. 14 • Environmental Health Perspectives • Mini-monograph on: Public Health Tracking • National Environmental Public Health Tracking Program: Bridging the Information Gap • Identifying Priority Health Conditions, Environmental Data and Infrastructure Needs: A Synopsis of the Pew Environmental Health Tracking Project (assessment conducted in 2001) (see biomonitoring handout for url for downloading these articles)

7. Biomonitoring - CDCEnvironmental Public Health Tracking Program CDC states: <http://www.cdc.gov/nceh/tracking/biomonitoring.htm> • Environmental Public Health Tracking is the ongoing collection, integration, analysis, interpretation, and dissemination of data on environmental hazards, exposures to those hazards, and related health effects. • The goal of tracking is to provide information that can be used to plan, apply, and evaluate actions to prevent and control environmentally related diseases. • Biomonitoring is a powerful tool essential for closing the gaps in exposure data. In many cases, data are not available on what substances are getting into people and at what levels.

9. BiomonitoringIssues Issues put forth in recent article in Science: “Pace of biomonitoring has eclipsed that of basic epidemiology and toxicology needed to reveal whether a chemical causes harm.” “Although testing for a chemical can take a few days, discernment of its impact on health takes years.” “High levels (of a chemical) are not necessarily dangerous, and typical levels are not necessarily safe.” Ref: Erik Stokstad, Pollution gets personal, News Focus article in Science, 304:1892-93, 2004.

10. Biomonitoringthe vision… Dr. Bill Suk predicted human biomonitoring may lead to: “…the identification of potentially hazardous exposures before the adverse health effects appear and to establish exposure limits minimizing likelihood of significant health risks.” Ref: Suk W., Human biomonitoring: research goals and needs, Environ Health Perspect, 104(Suppl 3):479-483, 1996. • Vision of biomonitoring’s scope - 1) Biomonitoring for chemical exposure assessment 2) Biomarkers of susceptibility (DNA repair) 3) Development of early biomarkers of the disease

11. BiomonitoringResearch studies • Sister Study <http://www.sisterstudy.org> • Exploring Gene-environmental interactions in 50,000 women whose sisters had breast cancer diagnosis • Extensive banking of blood and toe nail samples • Agricultural Health Study <http://www.aghealth.org> • Prospective study of a cohort of over 55,000 farmers and over 32,000 spouses • Extensive environmental monitoring and biomonitoring on a small subset of the farmers to measure pesticide exposure; will be use to develop models to predict exposures • BCERC (4 centers) <http://www.bcerc.org> • Biological basis of breast cancer • Environmental basis of puberty; some biomonitoring and gene-related biomarker development

12. BiomonitoringStrength and limitations • Brainstorm on: • Strengths • Limitations

13. BiomonitoringOutline and discussion Q’s • What are your questions about these approaches? • How will these approaches address questions you would like to see answered? • What are ways the cancer survivor community can communicate its priorities at the state and federal level?

14. Biomonitoring closing remarks…. • We hope this dialogue was informative and stimulating! • Thank you to all participants, and the NYSBCN for being such wonderful partners for this LDL event! • A reminder: Please turn in your evaluations to the facilitator at your site. • Safe travels, and Happy Valentines Day from all of us in BCERF!