NHANES Laboratory Component Geraldine McQuillan, Ph.D., Brenda Lewis, MPH, David Lacher, MD, Qiyuan...
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Transcript of NHANES Laboratory Component Geraldine McQuillan, Ph.D., Brenda Lewis, MPH, David Lacher, MD, Qiyuan...
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NHANES Laboratory ComponentGeraldine 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+) 1 3-mL Red 2 7-mL Red 2 15-mL Red 2 4 10-mL Red 1 10-mL EDTA (20+) 1
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Blood Collection Procedure• Administering a
questionnaire
• exclusions for hemophilia
• exclusion for chemotherapy (within 4 weeks)
• fasting questions (all 1+)
• 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-2001
Vaginal 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 2001Additional 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
pregnant women 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
bacterial resistance to antibiotics
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Additions to the Laboratory Component-2002
Vaginal Swab Collection (females age 14-59 years)• Human papillomavirus (HPV)
• One of the most common sexually transmitted infections in the U.S.
• Cervical infection with certain types of HPV is the strongest risk for cervical cancer.
• No national surveillance system to 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 care received