Reporting Exposure Biomonitoring Results to Study Participants: Challenges, Benefits, and Scalable MethodsAbstract Number:2199 Julia Brody*, Sarah Dunagan, Phil Brown, Rachel Morello-Frosch, Kenneth Arnold, and Krzysztof Gajos Julia Brody* Silent Spring Institute, United States, E-mail Address: [email protected] , Sarah Dunagan Silent Spring Institute, United States, E-mail Address: [email protected] , Phil Brown Northeastern University, United States, E-mail Address: [email protected] , Rachel Morello-Frosch University of California Berkeley, United States, E-mail Address: [email protected] , Kenneth Arnold Harvard University, United States, E-mail Address: [email protected] , and Krzysztof Gajos Harvard University, United States, E-mail Address: [email protected] AbstractEpidemiologic studies and public health biomonitoring rely on chemical exposure measurements in blood, urine, and other tissues, and in personal environments, such as homes. For many chemicals, the health implications of individual results are uncertain, and the sources and strategies to reduce exposure may not be known. In the past, researchers typically reported personal results only when they exceeded a clinical health guideline, but greater openness in medical practice and increased focus on participants' autonomy have shifted ethical approaches. Eight major ethics statements, including the National Academy of Sciences report on biomonitoring, call for reporting personal exposures; and the California state biomonitoring law requires it. To develop best-practice guidelines and new tools to ethically and effectively report personal exposure results, we interviewed participants, IRB representatives, and researchers in 7 studies and systematically coded and analyzed transcripts. Using results of this investigation, we are developing a digital interface for report-back and have conducted usability testing. Our report-back methods draw on risk communication and data visualization literatures as well as our case studies.Results of the case studies show that participants want to receive their results, can generally understand uncertainties about links to health, and are motivated to reduce exposures.Results reports supported community empowerment and policy change. Both narrative results and graphs are helpful. Comparisons of individual results with others in the study, national norms, and health guidelines are helpful. Researchers found that reporting individual results can prompt scientific insights and strengthen connections with cohort members. To facilitate adoption of effective report-back practices, we developed a handbook, including guidelines and examples ( http://bit.ly/N1K7WV).
In recent decades, there has been remarkable growth in scientific research examining the multiple ways in which racism can adversely affect health. This interest has been driven in part by the striking persistence of racial/ethnic inequities in health and ...Read More
Phosphate flame retardants (PFRs) have been used for years and are alternatives for phased-out polybrominated diphenyl ethers (PBDEs). PFRs are mainly used in FR mixtures, but also as plasticizers and in hydraulic fluids, solvents, antifoam agents, adhesives, and electronic coatings. They are abundant indoors and found at the highest house dust concentrations relative to other flame retardants. PFRs have been associated with neurotoxicity, hematological effects, endocrine disruption and cancer. Despite widespread use, little is known about biological levels or relationships with house dust concentrations, which provide insight into exposure pathways and potential health risks. We analyzed urine from 16 California residents in 2011 for 6 dialkyl phosphates (DAPs), the expected major metabolites of the most prominent PFRs, and qualitatively screened for 18 other metabolites predicted from in vitro metabolism studies. Comparison data are limited; we detected all 6 DAPs within the range of previously reported levels. We found weakly positive correlations between urine and dust concentrations. Homes with the highest dust concentrations of tris(1,3-dichloro- isopropyl) phosphate (TDCIPP) and tris(2-chloroethyl) phosphate (TCEP) had the highest urinary levels of bis(1,3-dichloro-2-propyl) phosphate (BDCIPP) and bis(2-chloroethyl) phosphate (BCEP), respectively. Metabolite levels were correlated for many PFRs, suggesting they commonly co-occur. To our knowledge, this is the first broad look at urinary concentrations of a key class of FR chemicals that appears to be increasing in use. Based on this study, as well as limited work identifying metabolites in in vitro liver preparations and limited in vivo work, we recommend further biomonitoring of the 6 DAPs we detected and TCEP, hydroxyphenyl phenyl phosphate, and 3 butoxyethyl phosphates. Future flame retardant studies should include biomonitoring of these important but poorly studied chemicals.
