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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 Prevention National Center for Health Statistics. NHANES Laboratory Component.

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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 Prevention

National Center for Health Statistics


Nhanes laboratory component
NHANES Laboratory Component

  • Specimen collection

  • Specimen processing

  • Specimen storage

  • Specimen shipping

  • Specimen testing

  • Quality control

    • Specimen tracking

    • Laboratory QC


Specimens collected

Blood

whole blood

serum

plasma

blood clots

Urine

Home tap water

Lead dust wipes

Swabs

nasal

vaginal

Specimens Collected



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

Blood Collection Procedure



Mec laboratory
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


Laboratory protocol
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


Nutrition laboratory tests
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


Environmental laboratory tests
Environmental Laboratory Tests

  • Lead

  • Cadmium

  • Blood and urine Mercury

  • Pesticides, persistent/non-persistent

  • Cotinine

  • Urinary Iodine

  • Lead Dust

  • Volatile organic compounds


Infectious disease laboratory tests
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


Chronic disease laboratory tests
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


Other laboratory tests
Other Laboratory Tests

  • Bone makers

    • Bone Alkaline Phosphatase

    • Urinary N-telopeptides

  • FSH/LH (females 35-60 yrs.)

  • Prostate Disease

    • Prostate Specific Antigen (males 40+)


Future research
Future Research

  • Separate consent and storage

    • Serum- Age 6+ years

    • Plasma- Age 6+ years

    • Urine- Age 6+ years

    • DNA- Age 20+ years


Additions to the laboratory component 2001
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


  • Nhanes 2001
    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 pregnant women are infected


  • Nhanes 20011
    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


  • Additions to the laboratory component 2002
    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 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


  • Nhanes 2002
    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


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