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The negative impact of lead exposure on young children and those who become pregnant is well documented but is not well known by those at highest risk from this hazard. Scientific evidence suggests that there is no known safe blood lead level (BLL), because even small amounts of lead can be harmful to a child's developing brain (1). In 2012, CDC introduced the population-based blood lead reference value (BLRV) to identify children exposed to more lead than most other children in the United States. The BLRV should be used as a guide to 1) help determine whether medical or environmental follow-up actions should be initiated for an individual child and 2) prioritize communities with the most need for primary prevention of exposure and evaluate the effectiveness of prevention efforts. The BLRV is based on the 97.5th percentile of the blood lead distribution in U.S. children aged 1-5 years from National Health and Nutrition Examination Survey (NHANES) data. NHANES is a complex, multistage survey designed to provide a nationally representative assessment of health and nutritional status of the noninstitutionalized civilian adult and child populations in the United States (2). The initial BLRV of 5 μg/dL, established in 2012, was based on data from the 2007-2008 and 2009-2010 NHANES cycles. Consistent with recommendations from a former advisory committee, this report updates CDC's BLRV in children to 3.5 μg/dL using NHANES data derived from the 2015-2016 and 2017-2018 cycles and provides helpful information to support adoption by state and local health departments, health care providers (HCPs), clinical laboratories, and others and serves as an opportunity to advance health equity and environmental justice related to preventable lead exposure. CDC recommends that public health and clinical professionals focus screening efforts on populations at high risk based on age of housing and sociodemographic risk factors. Public health and clinical professionals should collaborate to develop screening plans responsive to local conditions using local data. In the absence of such plans, universal BLL testing is recommended. In addition, jurisdictions should follow the Centers for Medicare & Medicaid Services requirement that all Medicaid-enrolled children be tested at ages 12 and 24 months or at age 24-72 months if they have not previously been screened (3).

Prostanoid receptors (nomenclature as agreed by the NC-IUPHAR Subcommittee on Prostanoid Receptors [694]) are activated by the endogenous ligands prostaglandins PGD2, PGE1, PGE2 , PGF2α, PGH2, prostacyclin [PGI2] and thromboxane A2. Differences and similarities between human and rodent prostanoid receptor orthologues, and their specific roles in pathophysiologic conditions are reviewed in [448]. Measurement of the potency of PGI2 and thromboxane A2 is hampered by their instability in physiological salt solution; they are often replaced by cicaprost and U46619, respectively, in receptor characterization studies.

Background Mercury is toxic to the developing brain, but the lowest concentration associated with the development of behavior problems is unclear. The purpose of this study was to examine the association between very low-level mercury exposure during fetal development and behavior problems in children. Methods We used data from 389 mothers and children in a prospective pregnancy and birth cohort study. We defined mean prenatal mercury concentration as the mean of total whole blood mercury concentrations in maternal samples collected at 16- and 26-weeks of gestation, delivery, and neonatal cord blood samples. We assessed parent-reported child behavior up to five times from two to 8 years of age using the Behavioral Assessment System for Children (BASC-2). At 8 years of age, we assessed self-reported child anxiety using the Spence Children’s Anxiety Scale (SCAS). We used multiple linear mixed models and linear regression models to estimate the association between mean prenatal mercury concentrations and child behavior and anxiety, respectively. Results The median prenatal total blood mercury concentrations was 0.67 μg/L. Overall, we did not find statistically significant associations between mean prenatal mercury concentrations and behavior problems scores, but a 2-fold increase in mercury concentrations at 16-weeks gestation was associated with 0.83 point (95% CI: 0.05, 1.62) higher BASC-2 anxiety scores. Maternal and cord blood mercury concentrations at delivery were associated with parent-reported anxiety at 8 years. Conclusion We found limited evidence of an association between very-low level prenatal mercury exposure and behaviors in children, with an exception of anxiety.

Purpose Dihydroxyacetone (DHA) is the only ingredient approved by the U.S. FDA as a color additive in sunless tanning (self-tanning) products. Consumer sunless tanning products available for retail purchase contain 1% to 15% DHA. Although originally thought to only interact with the stratum corneum, more recent research has shown that DHA penetrates beyond the stratum corneum to living keratinocytes indicating a possible route of exposure in the epidermis. Materials and methods Normal Human Epidermal Keratinocytes (NHEK) were used to determine any potential in vitro toxicological effects of DHA in the epidermis. NHEK cells exposed to DHA concentrations up to 0.90% (100 mM) in dosing media were evaluated for viability, genotoxicity (Comet Assay), and gene expression changes by microarray analysis. Results Cell viability significantly decreased ∼50% after 3-hour exposure to 50 and 100 mM DHA. DNA damage was only found to be significantly increased in cells exposed to cytotoxic DHA concentrations. A subtoxic dose of DHA induced significant gene expression changes. Particularly, expression of cyclin B1, CDK1, and six other genes associated with the G2/M cell cycle checkpoint were significantly decreased which correlates well with a G2/M block reported in existing literature. Advanced Glycation End Product (AGE) formation significantly increased after 24 hours of DHA exposure at and above 10 mM. In summary, these data show that DHA is cytotoxic above 25 mM in primary keratinocytes. Genotoxicity was detected only at cytotoxic concentrations, likely indicative of non-biologically relevant DNA damage, while subtoxic doses induce gene expression changes and glycation. Conclusion DHA treatment had a significant and negative effect on primary keratinocytes consistent with in vitro cultured cell outcomes; however, more information is needed to draw conclusions about the biological effect of DHA in human skin.

Objective The objective of the current study is to report on urine, blood and serum metal concentrations to characterize exposures to trace elements and micronutrient levels in both pregnant women and women of child-bearing age in the U.S. National Health and Nutrition Examination Survey (NHANES) years 1999–2016. Methods Urine and blood samples taken from NHANES participants were analyzed for thirteen urine metals, three blood metals, three serum metals, speciated mercury in blood and speciated arsenic in urine. Adjusted and unadjusted least squares geometric means and 95% confidence intervals were calculated for all participants among women aged 15–44 years. Changes in exposure levels over time were also examined. Serum cotinine levels were used to adjust for smoke exposure, as smoking is a source of metal exposure. Results Detection rates for four urine metals from the ATSDR Substance Priority List: arsenic, lead, mercury and cadmium were ~83–99% for both pregnant and non-pregnant women of child bearing age. A majority of metal concentrations were higher in pregnant women compared to non-pregnant women. Pregnant women had higher mean urine total arsenic, urine mercury, and urine lead; however, blood lead and mercury were higher in non-pregnant women. Blood lead, cadmium, mercury, as well as urine antimony, cadmium and lead in women of childbearing age decreased over time, while urine cobalt increased over time. Conclusions Pregnant women in the US have been exposed to several trace metals, with observed concentrations for some trace elements decreasing since 1999.

CDC designed a rapid HPGe Bioassay Method for 137Cs, 60Co, and 192Ir that is suitable for a public health response to a radiological incident where people may ingest or inhale radionuclides. The method uses a short count time, small sample volume, and a large volume detector and well size. It measures a patient's urine sample collected post-incident. The levels of concern are directly related to the Clinical Decision Guide levels recommended in the National Council of Radiation Protection 161.

Author(s): Mudan, Anita; Copan, Lori; Wang, Richard; Pugh, Amy; Lebin, Jacob; Barreau, Tracy; Jones, Robert L; Ghosal, Sutapa; Lee, Mai; Albertson, Timothy; Jarrett, Jeffery M; Lee, Jean; Betting, David; Ward, Cynthia D; De Leon Salazar, Alfonsina; Smollin, Craig G; Blanc, Paul D

Prostanoid receptors (nomenclature as agreed by the NC-IUPHAR Subcommittee on Prostanoid Receptors [644]) are activated by the endogenous ligands prostaglandins PGD2, PGE1, PGE2 , PGF2α, PGH2, prostacyclin [PGI2] and thromboxane A2. Measurement of the potency of PGI2 and thromboxane A2 is hampered by their instability in physiological salt solution; they are often replaced by cicaprost and U46619, respectively, in receptor characterization studies.

In 2015–2016, the U.S. Department of Health and Human Services led 23 U.S. Government (USG) agencies including the Centers for Disease Control and Prevention (CDC), and more than 120 subject matter experts in conducting an in-depth review of the U.S. core public health capacities and evaluation of the country’s compliance with the International Health Regulations using the Joint External Evaluation (JEE) methodology. This two-part process began with a detailed “self-assessment” followed by a comprehensive independent, external evaluation conducted by 15 foreign assessors. In the Radiation Emergencies Technical Area, on a scale from 1-lowest to 5-highest, the assessors concurred with the USG self-assessed score of 3 in both of the relevant indicators. The report identified 5 priority actions recommended to improve the USG capacity to handle large-scale radiation emergencies. CDC is working to implement a post-JEE roadmap to address these priority actions in partnership with national and international partners.

In 2012, the Centers for Disease Control and Prevention (CDC) adopted its Advisory Committee on Childhood Lead Poisoning Prevention recommendation to use a population-based reference value to identify children and environments associated with lead hazards. The current reference value of 5 μg/dL is calculated as the 97.5th percentile of the distribution of blood lead levels (BLLs) in children 1 to 5 years old from 2007 to 2010 NHANES data. We calculated and updated selected percentiles, including the 97.5th percentile, by using NHANES 2011 to 2014 blood lead data and examined demographic characteristics of children whose blood lead was ≥90th percentile value. The 97.5th percentile BLL of 3.48 µg/dL highlighted analytical laboratory and clinical interpretation challenges of blood lead measurements ≤5 μg/dL. Review of 5 years of results for target blood lead values

The Global Health Security Initiative (GHSI) established a laboratory network within the GHSI community to develop collective surge capacity for radionuclide bioassay in response to a radiological or nuclear emergency as a means of enhancing response capability, health outcomes and community resilience. GHSI partners conducted an exercise in collaboration with the WHO REMPAN (Radiation Emergency Medical Preparedness and Assistance Network) and the IAEA RANET (Response and Assistance Network), to test the participating laboratories (18) for their capabilities in in vitro assay of biological samples, using a urine sample spiked with multiple high-risk radionuclides (90Sr, 106Ru, 137Cs, and 239Pu). Laboratories were required to submit their reports within 72 hours following receipt of the sample, using a pre-formatted template, on the procedures, methods and techniques used to identify and quantify the radionuclides in the sample, as well as the bioassay results with a 95% confidence interval. All of the participating laboratories identified and measured all or some of the radionuclides in the sample. However, gaps were identified in both the procedures used to assay multiple radionuclides in one sample, as well as in the methods or techniques used to assay specific radionuclides in urine. Two third of the participating laboratories had difficulties in determining all the radionuclides in the sample. Results from this exercise indicate that challenges remain with respect to ensuring that results are delivered in a timely, consistent and reliable manner to support medical interventions. Laboratories within the networks are encouraged to work together to develop and maintain collective capabilities and capacity for emergency bioassay, which is an important component of radiation emergency response.

Iodine is an essential nutrient for normal growth and development. Iodine deficiency, which can cause intellectual impairment and brain damage, affects about 2 billion people worldwide. Severe iodine deficiency can result in a 10%–15% reduction in the IQ of a population. In the United States and many other countries, dairy products contribute the majority of daily iodine intake. According to a review of literature sources from all over the world, iodine nutritional status reflects changes in the dairy industry. Variables affecting the iodine content in dairy products include ration mixture, season, geographic region, sanitizing solutions, and supplements to the feed supply. Studies performed in the United States, Britain, Australia, New Zealand, and Norway showed this impact most noticeably. These studies investigate the relationship between dairy and iodine for various countries over the last six decades. Monitoring the correlation between iodine content in dairy products and population iodine status can help inform public health approaches to ensure adequate, safe, and balanced iodine intake.

The presence of metals in the environment is ubiquitous and humans are constantly being exposed to them. As such, a general concern exists about potential health consequences that result from the exposure to metals. The continued efforts of environmental scientists to measure metals in clinical specimens are important for defining the extent of human exposure to these chemicals. Laboratory methods to measure the concentration of metals in human blood or urine are available, and they can be used to assess the extent of human exposure to these chemicals. However, several considerations should be reviewed when requesting a laboratory measurement of metals because some factors can affect the test result or its interpretation. These considerations are discussed in this article and include pre-analytical, analytical, and post-analytical factors. Clinicians with this knowledge will be able to request these laboratory tests for their patients with enhanced confidence.

Background and objectives Some blood centers provide health screening as a public health measure and to encourage donation. The goal of the current study was to provide cardiovascular disease (CVD) screening to donors using high-throughput testing and web-based communications. Materials and methods CVD risk screening was offered to donors at selected mobile drives in a large metropolitan area. Risk factors were determined by donor questionnaire, laboratory testing (total cholesterol, HDL levels and hemoglobin A1c), and blood pressure measurement. Results were reported to participants via mail and website. A 60-day follow up web-based survey was sent to participants via email to assess the impact of the program on donor’s behavior. Results 9435 donors, 17–75 years old participated with the following risk factors: 61.3% BMIs > 25, 28.8% high total cholesterol, and 31.4% lower than recommended HDL levels. 25.3% of donors that responded to the follow up survey went to see their health care provider based on screening results and 9% of these received new or modified treatment. Conclusion In our sample, blood donors are healthier than the general population, but many still have CVD risk factors, particularly obesity. CVD screening can be successfully used to make donors aware of this important health information and some donors act on this information.

Background: Very high levels of prenatal maternal mercury have adverse effects on the developing fetal brain. It has been suggested that all possible sources of mercury should be avoided. However, although seafood is a known source of mercury, little is known about other dietary components that contribute to the overall levels of blood mercury. Objective: Our goal was to quantify the contribution of components of maternal diet to prenatal blood mercury level. Methods: Whole blood samples and information on diet and sociodemographic factors were collected from pregnant women (n = 4,484) enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC). The blood samples were assayed for total mercury using inductively coupled plasma dynamic reaction cell mass spectrometry. Linear regression was used to estimate the relative contributions of 103 dietary variables and 6 sociodemographic characteristics to whole blood total mercury levels (TBM; untransformed and log-transformed) based on R2 values. Results: We estimated that maternal diet accounted for 19.8% of the total variation in ln-TBM, with 44% of diet-associated variability (8.75% of the total variation) associated with seafood consumption (white fish, oily fish, and shellfish). Other dietary components positively associated with TBM included wine and herbal teas, and components with significant negative associations included white bread, meat pies or pasties, and french fries. Conclusions: Although seafood is a source of dietary mercury, seafood appeared to explain a relatively small proportion of the variation in TBM in our UK study population. Our findings require confirmation, but suggest that limiting seafood intake during pregnancy may have a limited impact on prenatal blood mercury levels. Citation: Golding J, Steer CD, Hibbeln JR, Emmett PM, Lowery T, Jones R. 2013. Dietary predictors of maternal prenatal blood mercury levels in the ALSPAC birth cohort study. Environ Health Perspect 121:1214–1218; http://dx.doi.org/10.1289/ehp.1206115

In this study, we evaluated the effect of temperature on the long-term stability of three mercury species in bovine blood. We used inductively coupled plasma mass spectrometry (ICP-MS) analysis to determine the concentrations of inorganic (iHg), methyl (MeHg) and ethyl (EtHg) mercury species in two blood pools stored at temperatures of -70, -20, 4, 23°C (room temperature) and 37°C. Over the course of a year, we analyzed aliquots of pooled specimens at time intervals of 1, 2, 4 and 6 weeks and 2, 4, 6, 8, 10 and 12 months. We applied a fixed-effects linear model, step-down pairwise comparison and coefficient of variation statistical analysis to examine the temperature and time effects on changes in mercury species concentrations. We observed several instances of statistically significant differences in mercury species concentrations between different temperatures and time points; however, with considerations of experimental factors (such as instrumental drift and sample preparation procedures), not all differences were scientifically important. We concluded that iHg, MeHg and EtHg species in bovine whole blood were stable at -70, -20, 4 and 23°C for 1 year, but blood samples stored at 37°C were stable for no more than 2 weeks.

Background Lead exposure is associated with elevated blood pressure during pregnancy; however, the magnitude of this relationship at low exposure levels is unclear. Objectives Our goal was to determine the association between low-level lead exposure and blood pressure during late pregnancy. Methods We collected admission and maximum (based on systolic) blood pressures during labor and delivery among 285 women in Baltimore, Maryland. We measured umbilical cord blood lead using inductively coupled plasma mass spectrometry. Multivariable models were adjusted for age, race, median household income, parity, smoking during pregnancy, prepregnancy body mass index, and anemia. These models were used to calculate benchmark dose values. Results Geometric mean cord blood lead was 0.66 μg/dL (95% confidence interval, 0.61–0.70). Comparing blood pressure measurements between those in the highest and those in the lowest quartile of lead exposure, we observed a 6.87-mmHg (1.51–12.21 mmHg) increase in admission systolic blood pressure and a 4.40-mmHg (0.21–8.59 mmHg) increase in admission diastolic blood pressure after adjustment for confounders. Corresponding values for maximum blood pressure increase were 7.72 (1.83–13.60) and 8.33 (1.14–15.53) mmHg. Benchmark dose lower limit values for a 1-SD increase in blood pressure were < 2 μg/dL blood lead for all blood pressure end points. Conclusions A significant association between low-level lead exposures and elevations in maternal blood pressure during labor and delivery can be observed at umbilical blood lead levels < 2 μg/dL.

Background: Metals can interfere with hormonal functioning by binding at the receptor site and through indirect mechanisms; thus, they may be associated with hormonal changes in premenopausal women. Objectives: We examined the associations between cadmium, lead, and mercury, and anovulation and patterns of reproductive hormones [estradiol, progesterone, follicle-stimulating hormone (FSH), luteinizing hormone] among 252 premenopausal women 18–44 years of age who were enrolled in the BioCycle Study in Buffalo, New York. Methods: Women were followed for up to two menstrual cycles, with serum samples collected up to eight times per cycle. Metal concentrations were determined at baseline in whole blood by inductively coupled mass spectroscopy. Marginal structural models with stabilized inverse probability weights and nonlinear mixed models with harmonic terms were used to estimate the effects of cadmium, lead, and mercury on reproductive hormone levels during the menstrual cycle and anovulation. Results: Geometric mean (interquartile range) cadmium, lead, and mercury levels were 0.29 (0.19–0.43) μg/L, 0.93 (0.68–1.20) μg/dL, and 1.03 (0.58–2.10) μg/L, respectively. We observed decreases in mean FSH with increasing cadmium [second vs. first tertile: –10.0%; 95% confidence interval (CI), –17.3% to –2.5%; third vs. first tertile: –8.3%; 95% CI, –16.0% to 0.1%] and increases in mean progesterone with increasing lead level (second vs. first tertile: 7.5%; 95% CI, 0.1–15.4%; third vs. first tertile: 6.8%; 95% CI, –0.8% to 14.9%). Metals were not significantly associated with anovulation. Conclusions: Our findings support the hypothesis that environmentally relevant levels of metals are associated with modest changes in reproductive hormone levels in healthy, premenopausal women.

Staphylococcal enterotoxin B (SEB) is an extracellular pyrotoxin produced by Staphylococcus aureus, a known etiologic agent of food poisoning in humans. Lateral flow immunochromatographic devices (LFDs) designed for the environmental detection of SEB were adapted for use in this study to detect SEB in milk containing 2 fat, chocolate-flavored milk, and milk-derived products such as yogurt, infant formula, and ice cream. The advantage of using LFDs in these particular food products was its ease and speed of use with no additional extraction methods needed. No false positives were observed with any of the products used in this study. Dilution of the samples overcame the Hook effect and permitted capillary flow into the membrane. Thus, semisolid products such as ice cream and some yogurts, and products containing thickeners needed to be diluted using a phosphate-buffered saline-based buffer, pH 7.2. SEB was easily detected at concentrations of 5 g/mL and 500 ng/mL when the LFDs were used. SEB was also reliably detected at concentrations below 5 and 0.25 ng/mL, which may induce serious disease.

Because the toxicological effects of mercury (Hg) are more serious in the developing central nervous system of children than adults, there are growing concerns about prenatal and early childhood Hg exposure. This study examined postnatal methylmercury (MeHg) exposure and cognition and behavior in 780 children enrolled in the Treatment of Lead (Pb)-exposed Children clinical trial (TLC) with 396 children allocated to the succimer and 384 to the placebo groups. Mercury exposure was determined from analyses of blood drawn 1 week before randomization and 1 week after treatment began when succimer had its maximal effect on blood Pb (PbB). The baseline MeHg concentrations were 0.54 microg/L and 0.52 microg/L and post-treatment concentrations were 0.51 microg/L and 0.48 microg/L for placebo and succimer groups, respectively. Because the baseline characteristics in the two groups were balanced and because succimer had little effect on MeHg concentration and no effect on the cognitive or behavioral test scores, the groups were combined in the analysis of MeHg and neurodevelopment. The children's IQ and neurobehavioral performance were tested at age 2, 5 and 7 years. We saw weak, non-significant but consistently positive associations between blood MeHg and IQ test scores in stratified, spline regression and generalized linear model data analyses. The behavioral problem scores were constant or decreased slightly with increasing MeHg concentration. Additional adjustment for PbB levels in multivariable models did not alter the conclusion for MeHg and IQ scores, but did confirm that concurrent PbB was strongly associated with IQ and behavior in TLC children. The effects of MeHg on neurodevelopmental indices did not substantially differ by PbB strata. We conclude that at the present background postnatal MeHg exposure levels of US children, adverse effects on children's IQ and behavior are not detectable.

Background Adverse health effects of cadmium in adults are well documented, but little is known about the neuropsychological effects of cadmium in children, and no studies of cadmium and blood pressure in children have been conducted. Objective We examined the potential effects of low-level cadmium exposure on intelligence quotient, neuropsychological functions, behavior, and blood pressure among children, using blood cadmium as a measure of exposure. Methods We used the data from a multicenter randomized clinical trial of lead-exposed children and analyzed blood cadmium concentrations using the whole blood samples collected when children were 2 years of age. We compared neuropsychological and behavioral scores at 2, 5, and 7 years of age by cadmium level and analyzed the relationship between blood cadmium levels at 2 years of age and systolic and diastolic blood pressure at 2, 5, and 7 years of age. Results The average cadmium concentration of these children was 0.21 μg/L, lower than for adults in the National Health and Nutrition Examination Survey (NHANES), but comparable to concentrations in children < 3 years of age in NHANES. Except for the California Verbal Learning Test for Children, there were no differences in test scores among children in different cadmium categories. For children with detectable pretreatment blood cadmium, after adjusting for a variety of covariates, general linear model analyses showed that at none of the three age points was the coefficient of cadmium on Mental Development Index or IQ statistically significant. Spline regression analysis suggested that behavioral problem scores at 5 and 7 years of age tended to increase with increasing blood cadmium, but the trend was not significant. We found no significant associations between blood cadmium levels and blood pressure. Conclusion We found no significant associations between background blood cadmium levels at 2 years of age and neurodevelopmental end points and blood pressure at 2, 5, and 7 years of age. The neuropsychological or hypertensive effects from longer background exposures to cadmium need further study.

Since 1971, the general U.S. population has been monitored for dietary iodine sufficiency by urinary iodine (UI) measurements through the National Health and Nutrition Examination Survey (NHANES). This report presents the UI levels for the population participating in NHANES 2003-2004. It is the third assessment of the U.S. population since NHANES III (1988-1994), when the median UI level was observed to decrease from NHANES I (1971-1974).In 2003-2004, a stratified, multistage, probability sample of approximately 5000 participants per year were selected to participate in NHANES Household interviews, and specimen collection were performed. UI level was measured by inductively coupled plasma mass spectrometry on a random subsample of 2526 participants aged 6 years and older.The median UI level for the general U.S. population in 2003-2004 was 160 microg/L (95% confidence interval [CI] 146-172), and 11.3 +/- 1.8% of the population had a UI level below 50 microg/L. Children had a higher UI level than adolescents and adults. Among all (pregnant and nonpregnant) women of reproductive age, the median UI level was 139 microg/L (95% CI 117-156), 15.1 +/- 3.2% women had a UI level50 microg/L, and Non-Hispanic blacks in this group had a lower UI level than other racial/ethnic groups.These findings affirm the stabilization of the UI level and the adequate iodine nutrition in the general U.S. population since 2000. Future surveys designed to achieve UI levels representative of pregnant women can improve the estimate of iodine sufficiency in this population subgroup. Continued monitoring of the population for iodine sufficiency is warranted because of groups at risk for iodine deficiency disorders.

The purpose of the study was to assess the neurocognitive status of 6-month-old infants whose mothers were exposed to low but varying amounts of lead during pregnancy. Lead levels in the cord blood were used to assess environmental exposure and the Fagan Test of Infant Intelligence (FTII) assessed visual recognition memory (VRM). The cohort consisted of 452 infants of mothers who gave birth to babies at 33-42 weeks of gestation between January 2001 and March 2003. The overall mean lead level in the cord blood was 1.42 microg/dl (95% CI: 1.35-1.48). We found that VRM scores in 6 month olds were inversely related to lead cord blood levels (Spearman correlation coefficient -0.16, p=0.007). The infants scored lower by 1.5 points with an increase by one unit (1 microg/dl) of lead concentration in cord blood. In the lower exposed infants (1.67 microg/dl) the mean Fagan score was 61.0 (95% CI: 60.3-61.7) and that in the higher exposed group (>1.67 microg/dl) was 58.4 (95% CI: 57.3-59.7). The difference of 2.5 points was significant at the p=0.0005 level. The estimated risk of scoring the high-risk group of developmental delay (FTII classification 3) due to higher lead blood levels was two-fold greater (OR=2.33, 95% CI: 1.32-4.11) than for lower lead blood levels after adjusting for potential confounders (gestational age, gender of the child and maternal education). As the risk of the deficit in VRM score (Fagan group 3) in exposed infants attributable to Pb prenatal exposure was about 50%, a large portion of cases with developmental delay could be prevented by reducing maternal blood lead level below 1.67 microg/dl. Although the negative predictive value of the chosen screening criterion (above 1.67 microg/dl) was relatively high (89%) its positive predictive value was too low (22%), so that the screening program based on the chosen cord blood lead criterion was recommended.

Mercury can be present in the body as inorganic mercury (mostly Hg2+), metallic mercury (elemental, Hg0), and organic mercury (mostly methylmercury). Common inorganic sources include air and water pollution, some skin creams, and herbal medicines. Seafood (including fish) consumption is a major contributor of methylmercury to blood total mercury; metallic mercury typically comes from amalgam dental fillings and industrial exposure. Although inhaled metallic mercury is a less common source of blood mercury, in humans about 80% of inhaled metallic vapor is retained by the body [World Health Organization (WHO) Task Group 1991]. It has a half-life in blood of about 60 days (range, 31–100) (Counter and Buchanan 2004). Like methyl-mercury, after crossing the blood–brain barrier, metallic mercury can be oxidized to inorganic mercury, which does not freely return to the circulation, resulting in accumulation in the brain. Much more mercury ends up in the brain of mice and monkeys after inhalation of the metallic form than after injection of the inorganic form (WHO Task Group 1991). The collapse of the World Trade Center (WTC) towers on 11 September 2001 resulted in the dispersion of many potentially harmful pollutants, including heavy metals (Lioy et al. 2002; McGee et al. 2003; Offenberg et al. 2003). Hundreds of thousands of gallons of airplane fuel, stored diesel fuel, and gasoline in vehicles parked beneath the buildings burned there, releasing some mercury into the air. Metallic mercury was also released with the crushing of tens of thousands of fluorescent light bulbs, major brands of which contain 3.5–15 mg of metallic mercury in a 4-foot bulb (Inform, Inc. 2003). In addition, nearly half of the demolished automobiles would have contained at least one hood or trunk light, or antilock braking system switch bearing metallic mercury (Adsit et al. 2002), each containing about 1,000 mg of metallic mercury [U.S. Environmental Protection Agency (EPA) 2005]. Other possible mercury sources included cathode ray tubes, such as those used for computer screens, and industrial switches and relays, which can contain from 1 to 91,000 g of metallic mercury (U.S. EPA 2002). Maternal exposure to methylmercury has been associated with decrements in cognitive function in the child (Budtz-Jorgensen et al. 2007; Grandjean et al. 1997, 2005; Jedrychowski et al. 2006; Oken et al. 2005). The developmental effects of maternal inhalation of low levels of metallic mercury vapor during pregnancy have been explored primarily in animals [reviewed by Counter and Buchanan (2004)]; however, in a study of women in Tagum, the Philippines, a fish-eating community using metallic mercury in gold mining/processing, cord blood total mercury was associated with developmental and language deficits at 2 years of age (Ramirez et al. 2003). A few studies have shown a relationship between occupational mercury exposure and various adverse reproductive outcomes using work setting or hair levels to define exposure (Seidler et al. 1999; Sikorski et al. 1986). Less is known about the relation to birth outcomes of lower-level, nonoccupational, metallic mercury exposure. A study, using questionnaires to assess exposure, of pregnant women having mercury dental fillings replaced during pregnancy showed no reductions in newborn birth weight (Hujoel et al. 2005). To evaluate the relation of blood total mercury to birth outcomes and child development, we used data collected in a study of the effects of the WTC attack of 11 September 2001 on women delivering several months after the event. We measured total mercury in maternal and cord blood, a measurement that reflects methylmercury from fish consumption, as well as inorganic and metallic mercury. We explored the relation of blood total mercury to proximity to the WTC and hypothesized that higher blood total mercury levels, whatever their source, would be associated with differences in birth outcomes and adversely affect child development, as measured by the Bayley Scales of Infant Development (2nd ed., BSID-II) (Bayley 1993) at 12, 24, and 36 months, and the Wechsler Preschool and Primary Scale of Intelligence, Revised (WPPSI-R) (Wechsler 1989), at 48 months. Although consumption of fish has been shown to be associated with higher maternal and/or cord mercury concentrations (Daniels et al. 2004; Jedrychowski et al. 2006), significantly higher infant scores on the MacArthur Communicative Development Inventory at 15 months and on the Denver Developmental Screening Test at 18 months have been associated with increasing fish intake during pregnancy (Daniels et al. 2004). Therefore, we also evaluated whether maternal fish/seafood consumption would have a protective effect on the child’s cognitive development and whether, by including it in the analyses, we would more clearly detect detrimental effects of prenatal mercury exposure.

Background: Although the maternal fish consumption is supposed to have beneficial effects on development of infants, it may be harmful for child cognitive development since fish is a common source of methylmercury. Purpose of the study: Purpose of the study was to describe the usual pattern of fish consumption during pregnancy in Poland and explain the variability of prenatal mercury exposure due to fish intake by mothers. The other endpoint of the study was the assessment of the cognitive and psychomotor development of infants related to prenatal mercury exposure over the 3-year follow-up. Material and methods: The study sample consisted of 374 infants born at 33–42 weeks of gestation between January 2001 and March 2003 to mothers attending ambulatory prenatal clinics in the first and second trimesters of pregnancy. Total mercury level in whole cord blood was measured and the Bayley Scales of Infant Development (BSID-II) was used to assess the mental (MDI) and psychomotor developmental index (PDI) in children at 12, 24 and 36 months of age. Results: Self-reported weekly amount of fish consumption during the first two trimesters of pregnancy correlated positively with umbilical cord mercury concentrations (rs=0.22, p

Over the last several decades, mass poisonings of diethylene glycol (DEG), usually ingested as an unintended component of pharmaceutical preparations, have occurred. In order to promptly halt the rise in deaths due to ingestion of these pharmaceuticals, laboratory analysis has often been employed to identify and quantify the etiologic agent after the medications have been tentatively implicated. Over the past 15 years, the Centers for Disease Control and Prevention has been involved in identifying DEG in implicated pharmaceutical products during three poisoning epidemics that occurred in Nigeria (1990), Haiti (1995), and, most recently, in Panama (2006). In each case, the timeliness of the identification was paramount in reducing the mortality involved in these mass poisonings. Using state-of-the-art analytical technology, we were able to provide initial identification of DEG within 24 h of receiving samples for each epidemic, allowing a timely public health response. However, over the past 15 years, the analytical instrumentation available and the laboratory responses undertaken have changed. In addition, the type of information and the degree of confirmation of results requested during each epidemic varied based upon the number of individuals involved and the political tenor involved with the outbreak. We describe our historical approach to identifying and quantifying DEG during each of these outbreaks. Furthermore, the reoccurrence of outbreaks has prompted us to establish standard technology to use in potential future outbreaks to allow an even more timely response. This methodology includes the development of biomarkers of DEG exposure, which would be extremely useful in instances where pharmaceuticals are not clearly implicated.

Background Sixteen children diagnosed with acute leukemia between 1997 and 2002 lived in Churchill County, Nevada, at the time of or before their illness. Considering the county population and statewide cancer rate, fewer than two cases would be expected. Objectives In March 2001, the Centers for Disease Control and Prevention led federal, state, and local agencies in a cross-sectional, case-comparison study to determine if ongoing environmental exposures posed a health risk to residents and to compare levels of contaminants in environmental and biologic samples collected from participating families. Methods Surveys with more than 500 variables were administered to 205 people in 69 families. Blood, urine, and cheek cell samples were collected and analyzed for 139 chemicals, eight viral markers, and several genetic polymorphisms. Air, water, soil, and dust samples were collected from almost 80 homes to measure more than 200 chemicals. Results The scope of this cancer cluster investigation exceeded any previous study of pediatric leukemia. Nonetheless, no exposure consistent with leukemia risk was identified. Overall, tungsten and arsenic levels in urine and water samples were significantly higher than national comparison values; however, levels were similar among case and comparison groups. Conclusions Although the cases in this cancer cluster may in fact have a common etiology, their small number and the length of time between diagnosis and our exposure assessment lessen the ability to find an association between leukemia and environmental exposures. Given the limitations of individual cancer cluster investigations, it may prove more efficient to pool laboratory and questionnaire data from similar leukemia clusters.

Background. Although mercury is toxic, few studies have measured exposure in children who handled elemental mercury briefly. In 2004, a student spilled approximately 60 milliliters of mercury at a Nevada school. Within 12 hours, all students were removed from the source of exposure. We conducted an exposure assessment at the school. Methods. We administered questionnaires and obtained urine samples from students. Using two-sample t-tests, we compared urine mercury levels from students who self-reported exposure to mercury levels of other students. Results. Two-hundred students participated, including 55/62 (89%) who were decontaminated. The students' geometric mean urine mercury level was 0.36 μg/L (95% confidence interval 0.32–0.40 μg/L). The student who brought the mercury to school was the only one to have an elevated urine mercury level (11.4 μg/L). Conclusion. Despite environmental contamination, mercury exposure may have been minimized because of rapid identification of the elemental mercury spill a...

There is little published literature on the efficacy of strategies to reduce exposure to residential well water arsenic. The objectives of our study were to: 1) determine if water arsenic remained a significant exposure source in households using bottled water or point-of-use treatment systems; and 2) evaluate the major sources and routes of any remaining arsenic exposure. We conducted a cross-sectional study of 167 households in Maine using one of these two strategies to prevent exposure to arsenic. Most households included one adult and at least one child. Untreated well water arsenic concentrations ranged from

The objective of this study was to investigate the perceived increase in resistance of Streptococcus equi subsp. zooepidemicus ( S. zooepidemicus) isolated from the lower respiratory tract of horses to trimethoprim–sulfamethoxazole (SXT). The recorded SXT-susceptibility results of 50 S. zooepidemicus isolates from the tracheal wash fluid of equine patients examined at Colorado State University Veterinary Teaching Hospital from each of 2 time periods (1987–1990 and 1997–2001) were compared and statistically analyzed using a cross-sectional study design. There was a statistically significant difference between the documented resistance of S. zooepidemicus isolated in the 1987–1990 time period (8%), using quantitative microbroth dilution, and the resistance reported for isolates from the 1997–2001 time period (42%), using Kirby–Bauer agar disk diffusion. Laboratory investigation revealed inadequate quality control of media and subsequent falsely reported resistance of S. zooepidemicus from 1997 to 2001 time period. This study demonstrates how minor deviations from prescribed laboratory-testing guidelines can have a major effect on antimicrobial susceptibility test results. The study also underscores the need for regular surveillance and monitoring of trends in antimicrobial susceptibility to detect and correct such problems. In addition, epidemiologists and others collecting data from laboratories should be cautioned to interact with the laboratory regarding interpretation of results of various testing methods to ensure accurate analysis and conclusions.

In 2001 the Centers for Disease Control and Prevention (CDC) established a program, Ensuring the Quality of Urinary Iodine Procedures (EQUIP); to assist laboratories around the world and assess the accuracy of their urinary iodine (UI). CDC designed EQUIP to issue unknown specimens to participating laboratories three times per year. Each laboratory was asked to analyze unknown samples in duplicate on three different days. During the first five rounds of EQUIP, 41 laboratories participated, measuring unknown samples and reporting their results to CDC. CDC used these results to prepare a statistical report for the laboratories. Feedback to the laboratories provided external confirmation regarding performance. As a group, laboratory performance improved; several laboratories made considerable improvement. Several laboratories that showed no improvement have ordered new equipment or are arranging for additional training. EQUIP is a key tool used to support laboratory quality assurance in an effort to eliminate iodine deficiency disorders (IDD) in the world.

We have characterized environmental exposures among 187 women who were pregnant, were at or near the World Trade Center (WTC) on or soon after 11 September 2001, and are enrolled in a prospective cohort study of health effects. Exposures were assessed by estimating time spent in five zones around the WTC and by developing an exposure index (EI) based on plume reconstruction modeling. The daily reconstructed dust levels were correlated with levels of particulate matteror = 2.5 microm in aerodynamic diameter (PM2.5; r = 0.68) or PM10 (r = 0.73-0.93) reported from 26 September through 8 October 2001 at four of six sites near the WTC whose data we examined. Biomarkers were measured in a subset. Most (71%) of these women were located within eight blocks of the WTC at 0900 hr on 11 September, and 12 women were in one of the two WTC towers. Daily EIs were determined to be highest immediately after 11 September and became much lower but remained highly variable over the next 4 weeks. The weekly summary EI was associated strongly with women's perception of air quality from week 2 to week 4 after the collapse (p0.0001). The highest levels of polycyclic aromatic hydrocarbon-deoxyribonucleic acid (PAH-DNA) adducts were seen among women whose blood was collected sooner after 11 September, but levels showed no significant associations with EI or other potential WTC exposure sources. Lead and cobalt in urine were weakly correlated with sigmaEI, but not among samples collected closest to 11 September. Plasma OC levels were low. The median polychlorinated biphenyl level (sum of congeners 118, 138, 153, 180) was 84 ng/g lipid and had a nonsignificant positive association with sigmaEI (p0.05). 1,2,3,4,6,7,8-Heptachlorodibenzodioxin levels (median, 30 pg/g lipid) were similar to levels reported in WTC-exposed firefighters but were not associated with EI. This report indicates intense bystander exposure after the WTC collapse and provides information about nonoccupational exposures among a vulnerable population of pregnant women.

Exposure to methyl mercury, a risk factor for neurodevelopmental toxicity, was assessed in U.S. children 1-5 years of age (n = 838) and women 16-49 years of age (n = 1,726) using hair mercury analysis during the 1999-2000 National Health and Nutrition Examination Survey (NHANES). The data are nationally representative and are based on analysis of cross-sectional data for the noninstitutionalized, U.S. household population. The survey consisted of interviews conducted in participants' homes and standardized health examinations conducted in mobile examination centers. Distributions of total hair mercury levels expressed as micrograms per gram hair Hg and the association of hair Hg levels with sociodemographic characteristics and fish consumption are reported. Geometric mean (standard error of the geometric mean) hair mercury was 0.12 microg/g (0.01 microg/g) in children, and 0.20 microg/g (0.02 microg/g) in women. Among frequent fish consumers, geometric mean hair mercury levels were 3-fold higher for women (0.38 vs. 0.11 micro g/g) and 2-fold higher for children (0.16 vs. 0.08 microg/g) compared with nonconsumers. The NHANES 1999-2000 data provide population-based data on hair mercury concentrations for women and children in the United States. Hair mercury levels were associated with age and fish consumption frequency.

Biological monitoring for occupational lead exposure involves routine venous blood draws from exposed employees. This uncomfortable procedure normally yields more blood than what is needed for analysis. Capillary blood sampling is less invasive but introduces the possibility of surface contamination. The objective of this study was to compare venous and capillary (earlobe) blood lead samples obtained from occupationally exposed individuals. Phlebotomists trained specifically in the collection of blood samples for lead determination collected 2 venous blood samples and 2 capillary earlobe samples from each participating employee. Before the capillary draw, the employee's earlobe was cleansed with an alcohol wipe in an effort to remove potential lead contamination. A second alcohol wipe was then used to sanitize the lancing area and was retained for lead analysis. Both the venous and capillary samples were subsequently analyzed with the use of graphite furnace atomic absorption spectrometry (GFAAS). GFAAS of venous blood specimens was considered the reference method of sampling and analysis. We collected and analyzed 126 paired earlobe and venous samples. Earlobe sampling was preferred to venous sampling by 54% of the employees surveyed. The mean difference between the capillary and venous results was 38.8 +/- 48.1 microg/dL. Lead concentrations in earlobe blood were more than twice those found in venous samples in more than half of the samples (64 of 126). Despite simple cleansing with an alcohol wipe and no visible skin contamination, 94% of the wipe samples from earlobes contained more than 1 microg of lead. Even low concentrations of contamination can significantly alter the concentration of lead in the blood; for example, sample contamination of 0.3 microg lead in a 200-microL blood sample would yield an increase of 150 microg/dL in the measured lead concentration. The findings of this study suggest that until satisfactory skin cleansing and decontamination techniques are identified and evaluated, earlobe sampling should be avoided in the surveillance of occupational blood lead levels.

Kyphosis has not been reported in any Graptemys species (map turtles and sawbacks). We captured four kyphotic individuals of Graptemys oculifera from the Pearl River system, Mississippi, with three individuals recaptured 5 to 12 yrs later; one juvenile female had measurable growth, and two adult females had negligible growth. All kyphotic individuals were females, with an overall occurrence rate of 0.10% (4 of 3830 individuals) at five G. oculifera sample sites.

The phase-out of leaded gasoline began in Jakarta, Indonesia on July 1, 2001. We evaluated mean blood lead levels (BLLs) and the prevalence of elevated BLLs of Jakarta school children and assessed risk factors for lead exposure in these children before the beginning of the phase-out activities. The study involved a population-based, cross-sectional blood lead survey that included capillary blood lead sampling and a brief questionnaire on risk factors for lead poisoning. A cluster survey design was used. Forty clusters, defined as primary schools in Jakarta, and 15 2nd- and 3rd-grade children in each cluster were randomly selected for participation in the study. The average age of children in this study was 8.6 years (range 6-12) and the geometric mean BLL of the children was 8.6 microg/dl (median: 8.6 microg/dl; range: 2.6-24.1 microg/dl) (n=397). Thirty-five percent of children had BLLs > or =10 microg/dl and 2.4% had BLLs > or =20 microg/dl. Approximately one-fourth of children had BLLs 10-14.9 microg/dl. In multivariate models, level of education of the child's primary caregiver, water collection method, home varnishing and occupational recycling of metals, other than lead, by a family member were predictors of log BLLs after adjustment for age and sex. BLLs of children who lived near a highway or major intersection were significantly higher than those of children who lived near a street with little or no traffic when level of education was not included in the model. Water collection method was a significant predictor of BLLs > or =10 microg/dl after adjustment for age and sex. BLLs in children in this study were moderately high and consistent with BLLs of children in other countries where leaded gasoline is used. With the phase-out of leaded gasoline, BLLs of children in Jakarta are expected to rapidly decline as they have in other countries that have phased lead out of gasoline.

SummaryHemophilia is an expensive disease because its treatment is heavily dependent on costly clotting factor drugs. Over the last nine years, a consortium of three Comprehensive Hemophilia Treatment Centers and other hospitals, which purchased clotting factors for their patients, has seen treatment costs escalate on average 17% annually. Currently, new, even more expensive drugs are entering the market.This study analyzes 3,244 purchases that were made over a nine-year period totaling nearly 500 million units of clotting factor, representing every product on the market. Purchases were made both apart from and under the Federal Public Health Service (PHS) discount pricing rules.The main cause of the increases was the move to newer, more expensive products. The average price of existing products increased less than 2% per year, but new products were priced, on average, 47% higher than existing products. Overall consumption increased by an average of 5% per year, likely reflecting prophylactic treatment modalities that require greater amounts of clotting factor. Government pricing programs, such as the PHS program, were ineffective or counterproductive at reducing costs.There is a notable absence of competition in this market, with a few dominant companies having a functional monopoly in the largest segments of the market. Prices of older products are not lowered, even when new products are brought to market. A few products that serve small patient groups have had their prices increased substantially.This escalation is likely to continue as new, more expensive clotting factor drugs are developed. Since these new products are not proven to be any safer or more effective than the current products, this situation creates a risk of intervention by government and insurers to address both treatment costs and exhaustion of patients’ insurance caps. Drug companies are not serving the patients by pricing new, but often very similar, products so aggressively. The trends seen in this patient group will likely be seen in other patient groups in the future. Ultimately, doctors and patients will lose treatment options and health care availability unless collaborative strategies are developed to reduce costs.

The immunogenicity and safety of a chromatographically purified rabies vaccine (CPRV) was evaluated using US veterinary medical students. In the first study, 242 healthy adults were enrolled in a randomized, modified double-blind, multicenter trial and received five doses of either CPRV or human diploid cell vaccine (HDCV) by intramuscular injection on days 0, 3, 7, 14, and 28 concurrently with human rabies immunoglobulin in a simulated post-exposure prophylaxis regimen. Post-immunization titers in the CPRV and HDCV groups reached 0.5 IU/ml (the WHO-recommended minimally acceptable titer) or greater in all subjects in both vaccine groups by day 14 and remained above that level through day 90. In the second study, 438 healthy adults were enrolled in a randomized, double-blind, multicenter trial and assigned to receive five doses from one of three lots of CPRV by intramuscular injection on days 0, 3, 7, 14, and 28 in a simulated post-exposure prophylaxis regimen to evaluate lot consistency. Post-immunization titers rapidly increased to over 0.5 IU/ml by day 14 for all subjects and remained above that level through day 42 when the study was terminated. The three lots were considered equivalent. The percentage of subjects with at least one local reaction during the five-dose regimen was slightly lower in the CPRV group than in the HDCV group (P=0.06). The most frequently reported local reaction for all doses of vaccine was pain at the injection site. Headache, myalgia, and malaise were the most frequently reported systemic events. The percentage of subjects with at least one systemic event was significantly lower for CPRV (P=0.0084). No vaccine-related serious adverse reaction was reported in these studies. The results of these studies indicate that CPRV administered intramuscularly to healthy adults is immunogenic and is associated with fewer local and systemic reactions than HDCV.

Background: Lead testing on dried filter paper (FP) blood spots is used routinely by some laboratories for lead poisoning screening. Proficiency testing (PT) as required under CLIA ‘88 laboratory regulations has not been available for these methods. Methods: We describe a suitable PT scheme and evaluate FP laboratory performance based on program results. Monthly testing events consisting of five FP specimens were provided to six participating laboratories. Results were evaluated against target values determined by referee laboratories. Results: Preliminary FP laboratory results showed poor agreement with specimen target values, exhibiting a mean absolute bias of 0.29 μmol/L (5.9 μg/dL). Five of six participating laboratories demonstrated significant improvement in later testing events, with bias decreasing to 0.12 μmol/L (2.5 μg/dL). Performance varied widely between the participating laboratories and appeared to be method dependent. When evaluated using CLIA blood lead acceptability criteria, the proportion of acceptable individual specimen results (n = 35) ranged from 54% to 100%. On a testing event basis (n = 7), the proportion of acceptable events ranged from 29% to 100%. Conclusions: A suitable FP PT program now exists to capably assist and monitor FP laboratories. Based on overt PT results, properly utilized FP testing methods can accurately measure blood lead concentration.

PURPOSE The Treatment of Lead-exposed Children (TLC) trial tested whether developmental outcome differed between children treated for lead poisoning with succimer or placebo. On 7 July 1997, TLC was informed that the vitamin and mineral supplements it gave to all children were contaminated with about 35 microg of lead per tablet. METHODS TLC recalled the contaminated supplements and measured the children's exposure. RESULTS The families of 96% of the children were contacted with 30 days. Among the 571 children to whom the contaminated supplements were dispensed, the mean increase in blood lead was 0.06+/-0.01 micromol/L (1.2+/-0.2 microg/dL); among 78 children to whom they were not, it was 0.09+/-0.03 micromol/L (1.8+/-0.7 microg/dL). There was no evidence of a dose-response relation between estimated supplement consumption and increase in blood lead concentration. CONCLUSIONS The children's blood lead concentrations were not detectably affected by the contamination. Since the association of cognitive delay with lead exposure is best described for blood lead, we believe that the trial's inference about the effect of drug therapy on lead induced cognitive delay should be unaffected.

Iodine intake is essential for normal growth, development and metabolism throughout life, especially for women during gestation and lactation. The present study applies a novel statistical approach, providing smoothed urinary iodine (UI) percentile curves for the total US population as well as the categories of sex, race/ethnicity, women of childbearing age and pregnant women who were participants in the National Health and Nutrition Examination Survey (NHANES) 2001-2010. To our knowledge, this is the first application of this technique to NHANES nutritional biomarker data.We used UI and urinary creatinine that were measured in participants aged 6 and older in the NHANES survey periods 2001-2002, 2003-2004, 2005-2006, 2007-2008 and 2009-2010. A nonparametric double-kernel method was applied to smooth percentile curves for UI and creatinine-corrected results.The UI population estimates showed a U-shaped distribution by age for the total US population. Overall, females had lower UI concentrations and median values compared to males (median UI for females, 141.8 µg/l; median UI for males, 176.1 µg/l; p0.0001). Non-Hispanic blacks had the lowest median UI concentrations compared to other racial/ethnic groups (p0.0001). Among women of childbearing age (15-44 years), UI concentrations mostly declined with increasing age. Pregnant women aged 35 years and older tended to have higher UI concentrations than younger pregnant women at similar percentiles.The smoothed reference distribution of UI concentrations provides an improved and visual display of the entire distribution of values for the US population and specific demographic categories.

An international workshop on emergency radiobioassay was held in Ottawa, Canada, 1-3 September 2010. Sixty-five scientists and public health officials from five countries attended the workshop and gave 36 presentations. During the workshop, many considerations were raised, gaps identified, and recommendations given for emergency radiobioassay for both preparedness and response in case of a radiological or nuclear incident. In short, some bioassay methods and protocols need to be developed, validated, and exercised; national and international radiobioassay laboratory networks should be established; and communications and collaborations among public health officials, monitoring experts, and medical staff are encouraged. All these activities are required to make us better prepared for an RN emergency. © Copyright 2011 Health Physics Society.

It is now more than 15 years since the molecular structures of the major prostanoid receptors were elucidated. Since then, substantial progress has been achieved with respect to distribution and function, signal transduction mechanisms, and the design of agonists and antagonists (http://www.iuphar-db.org/DATABASE/FamilyIntroductionForward?familyId=58). This review systematically details these advances. More recent developments in prostanoid receptor research are included. The DP(2) receptor, also termed CRTH2, has little structural resemblance to DP(1) and other receptors described in the original prostanoid receptor classification. DP(2) receptors are more closely related to chemoattractant receptors. Prostanoid receptors have also been found to heterodimerize with other prostanoid receptor subtypes and nonprostanoids. This may extend signal transduction pathways and create new ligand recognition sites: prostacyclin/thromboxane A(2) heterodimeric receptors for 8-epi-prostaglandin E(2), wild-type/alternative (alt4) heterodimers for the prostaglandin FP receptor for bimatoprost and the prostamides. It is anticipated that the 15 years of research progress described herein will lead to novel therapeutic entities.

There is a critical need for qualitative and quantitative methodologies that provide the rapid and accurate detection of food contaminants in complex food matrices. However, the sensitivity of the assay can be affected when antigen-capture is applied to certain foods or beverages that are extremely acidic. This study was undertaken to assess the effects of orange juice and popular carbonated soft drink upon the fidelity of antibody-based antigen-capture assays and to develop simple approaches that could rescue assay performance without the introduction of additional or extensive extraction procedures. We examined the effects of orange juice and a variety of popular carbonated soft drink beverages upon a quantitative Interleukin-2 (IL-2) enzyme-linked immunosorbent assay (ELISA) assay system and a lateral flow device (LFD) adapted for the detection of staphylococcal enterotoxin B (SEB) in foods. Alterations in the performance and sensitivity of the assay were directly attributable to the food matrix, and alterations in pH were especially critical. The results demonstrate that approaches such as an alteration of pH and the use of milk as a blocking agent, either singly or in combination, will partially rescue ELISA performance. The same approaches permit lateral flow to efficiently detect antigen. Practical Application: The authors present ways to rescue an ELISA assay compromised by acidity in beverages and show that either the alteration of pH, or the use of milk as a blocking agent are not always capable of restoring the assay to its intended efficiency. However, the same methods, when employed with lateral flow technology, are rapid and extremely successful.