mcquillan 2

7/29/2019 Mcquillan 2

1/19

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


2/19

NHANES Laboratory Component

Specimen collection

Specimen processing

Specimen storage

Specimen shipping

Specimen testing

Quality control Specimen tracking

Laboratory QC


3/19

Specimens Collected

Blood whole blood

serum

plasma

blood clots

Urine

Home tap water

Lead dust wipes

Swabs

nasal

vaginal


4/19

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


5/19

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


6/19

OP96010


7/19

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


8/19

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


9/19

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


10/19

Environmental Laboratory Tests

Lead

Cadmium

Blood and urine Mercury

Pesticides, persistent/non-persistent

Cotinine

Urinary Iodine

Lead Dust

Volatile organic compounds


11/19

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


12/19

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


13/19

Other Laboratory Tests

Bone makers

Bone Alkaline Phosphatase

Urinary N-telopeptides

FSH/LH (females 35-60 yrs.)

Prostate Disease

Prostate Specific Antigen (males 40+)


14/19

Future Research

Separate consent and storage

Serum- Age 6+ years

Plasma- Age 6+ years

Urine- Age 6+ years

DNA- Age 20+ years


15/19

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


16/19

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


17/19

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


18/19

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


19/19

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 carereceived

mcquillan 2

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