mcquillan 2
TRANSCRIPT
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NHANES Laboratory Component
Geraldine McQuillan, Ph.D., Brenda Lewis, MPH,
David Lacher, MD, Qiyuan Pan, Ph.D., NCHS
Barbara Lindstrom, M.SPH., Westat
Centers for Disease Control and PreventionNational Center for Health Statistics
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NHANES Laboratory Component
Specimen collection
Specimen processing
Specimen storage
Specimen shipping
Specimen testing
Quality control Specimen tracking
Laboratory QC
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Specimens Collected
Blood whole blood
serum
plasma
blood clots
Urine
Home tap water
Lead dust wipes
Swabs
nasal
vaginal
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Venipuncture Protocol
Age in Years 1-2 3-5 6-11 12+Tube Type Priority
3-mL Lavender 1 1 1 1
5-mL Lavender 1 1 2
3-mL Gray
(Morning sessions only)
1
3-mL Blue (40+) 13-mL Red 2
7-mL Red 2
15-mL Red 2 4
10-mL Red 110-mL EDTA (20+) 1
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Blood Collection Procedure Administering a
questionnaire
exclusions forhemophilia
exclusion for
chemotherapy(within 4 weeks)
fasting questions (all1+)
fasting (all SPs age 12 or more
years)
morning - 9 hrs
afternoon or evening -6
hrs.
Performing
venipuncture Collecting specimens
for special studies
collecting nasal
swab
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OP96010
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MEC Laboratory
CBC and differential
Pregnancy test
Blood and urine processing
290 laboratory assays 44 vials of blood
14 vials of urine
13 other containers (water, swabs, wipes)
28 laboratories
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Laboratory Protocol
Trends
assays the same or comparable across surveys
Complement the physical exam
bone markers
Bio-measurements (different measurements by age)
nutrition
environmental infectious disease
chronic diseases
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Nutrition Laboratory Tests
Iron Status Erythrocyte Protoporphyrin
Iron/TIBC
Ferritin
Vitamin Status
RBC Folate
Serum Folate/Vitamin B12
Vitamin A/E/Carotenoids
Vitamin D
Homocysteine/methylmalonic acid
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Environmental Laboratory Tests
Lead
Cadmium
Blood and urine Mercury
Pesticides, persistent/non-persistent
Cotinine
Urinary Iodine
Lead Dust
Volatile organic compounds
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Infectious Disease Laboratory Tests Hepatitis A, B, C, D, E
Sexually Transmitted Diseases
HIV
HSV-1 and 2
Chlamydia / Gonorrhea
Syphilis
Bacterial vaginosis /Trichomonas
HPV antigen and antibody Measles/Varicella/Rubella
MRSA
Toxoplasmosis
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Chronic Disease Laboratory Tests
Diabetes
Hemoglobin A1c
Glucose, Insulin and C-peptide
Heart Disease
Lipids, Fibrinogen, CRP
Thyroid Disease
TSH and Thyroxine
Kidney Disease
Urinary microalbumin
Clinical biochemistry profile - serum creatinine
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Other Laboratory Tests
Bone makers
Bone Alkaline Phosphatase
Urinary N-telopeptides
FSH/LH (females 35-60 yrs.)
Prostate Disease
Prostate Specific Antigen (males 40+)
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Future Research
Separate consent and storage
Serum- Age 6+ years
Plasma- Age 6+ years
Urine- Age 6+ years
DNA- Age 20+ years
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Additions to the Laboratory Component-
2001Vaginal Swab Collection (females age 14-49 years)
Bacterial vaginosis (BV)
Most common cause of vaginal discharge
Not an infection but a change in vaginal bacteria
Associated with premature labor and delivery
Infections after OB/GYN procedures
Trichomoniasis
Most common curable STD No population based data
Causes reproductive health problems in women
Males rarely have symptoms
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NHANES 2001
Additional Blood Tests
Syphilis (age 18-49 years)
Two tests will be done (RPR and EIA)
Measure of recent infection (both tests
positive) Measure of remote infection (EIA positive)
Toxoplasma gondii (age 6-49 years)
Foodborne infection
Can cause congenital infections if pregnantwomen are infected
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NHANES 2001
Additional Tests Prostate Specific Antigen (males age 40+)
Detects prostate disease/cancer
Nasal swab collection (ages 1+)
Methicillin-resistant Staph aureus
Assessment of community acquired bacterialresistance to antibiotics
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Additions to the Laboratory Component-
2002Vaginal Swab Collection (females age 14-59 years)
Human papillomavirus (HPV)
One of the most common sexually transmittedinfections in the U.S.
Cervical infection with certain types of HPV is the
strongest risk for cervical cancer. No national surveillance systemto measure the
burden of HPV infections in the U.S.
Blood collection
HPV-16 antibody, males and females ages 14-59 years To determine the prevalence of infection in the
population
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NHANES 2002
Follow-up Addition to Exam
Follow-up of HCV positive individuals
Phone survey 6 months after ROF sent
Questions on knowledge and health carereceived