Biomonitoring—the measure of environmental chemicals in people’s blood, urine and other fluids—becomes an even more powerful tool when coupled with environmental public health tracking. Tracking includes the ongoing
collection and interpretation of data on health effects and environmental expo-
sures. This information can be used to prevent and control environmental-related
diseases, with the ultimate goal of reducing exposure levels in a given population.
The Washington State Department of Health, with funding from CDC’s National
Center for Environmental Health, set out to develop this partnership between bio-monitoring and environmental public health tracking. Their specific goals include
understanding the amounts of environmental chemicals in the bodies of residents,
comparing state-wide levels to national levels and using the results to help reduce
potentially harmful exposures for Washingtonians.
From September 2009 to August 2011, the Washington Environmental Biomonitor-ing Survey staff collected 1,422 urine samples from a statewide, representative
sample of residents age 6 and older. Samples were analyzed at the public health
laboratory for total and speciated arsenic, 12 metals, and pyrethroid and organophosphate pesticide metabolites. Simultaneously, the Department of Health collected drinking water samples from 498 participants and the Washington Tracking
Network paid to test the samples for arsenic, cadmium, lead, thallium, uranium
by Surili Sutaria, MS, senior specialist,
The survey levels were compared with national levels documented by CDC in the
National Report on Human Exposure to Environmental Chemicals. 1 Some of the
major findings from this study conclude urine levels of total arsenic cadmium and
cobalt were higher in Washington compared to national levels, while cesium, lead
and thallium were lower. People who consumed seafood three days prior to giving
a sample revealed higher levels of arsenic in their urine. Results were reported to
participants in a letter, along with a toll-free number to call with questions.
Concurrently analyzing results for metals in urine and in drinking water painted a clearer picture
of the connection between a potential source and the level of exposure in the population.
In addition to uncovering these findings, the project led to several other
• Installation of state-of-the-art instruments for analysis of clinical specimens.
• Development of methods for metals speciation from clinical specimens by
HPLC-ICP-MS, for pyrethrin pesticide metabolites in urine, organophosphate
metabolites in urine, phthalate metabolites in urine, bisphenol A metabolites in
urine, and creatinine correction, all by HPLC-MS/MS.
• Adaptation of their Laboratory Information Management System (LIMS) to share
laboratory data with the epidemiology participant questionnaire database for
analysis of results.
• A close working relationship with the environmental epidemiologists and
toxicologists within the Department of Health.
Moving forward, Washington plans to develop laboratory methods for measuring
bisphenol A and phthalates2 in urine samples collected in the first and second
years of the grant. In addition, they plan to work with the Seattle & King County
Public Health Department to measure pyrethroid pesticides, bisphenol A and
phthalates in the urine of low-income Washington residents and compare the
results to those found at state and national levels. According to Washington’s
Health Equity project, studies show that these compounds may impact hormone
function early in life, and that people with lower incomes have higher levels of
these compounds in their bodies. Through these projects, Washington State Health
Department aims to understand how people are being exposed over time and to
identify potentially harmful exposures. u