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NHANES Laboratory Component

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  1. 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

  2. NHANES Laboratory Component • Specimen collection • Specimen processing • Specimen storage • Specimen shipping • Specimen testing • Quality control • Specimen tracking • Laboratory QC

  3. Blood whole blood serum plasma blood clots Urine Home tap water Lead dust wipes Swabs nasal vaginal Specimens Collected

  4. Venipuncture Protocol

  5. 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

  6. OP96010

  7. 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

  8. 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

  9. 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

  10. Environmental Laboratory Tests • Lead • Cadmium • Blood and urine Mercury • Pesticides, persistent/non-persistent • Cotinine • Urinary Iodine • Lead Dust • Volatile organic compounds

  11. 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

  12. 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

  13. Other Laboratory Tests • Bone makers • Bone Alkaline Phosphatase • Urinary N-telopeptides • FSH/LH (females 35-60 yrs.) • Prostate Disease • Prostate Specific Antigen (males 40+)

  14. Future Research • Separate consent and storage • Serum- Age 6+ years • Plasma- Age 6+ years • Urine- Age 6+ years • DNA- Age 20+ years

  15. 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

  16. 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

  17. 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

  18. 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

  19. 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