Rocky Mountain Biomonitoring Consortium Executive Summary
The Rocky Mountain Biomonitoring Consortium (RMBC) was formed to apply regional resources to address environmental public health problems in the states of Arizona, Colorado, Montana, New Mexico, Utah, and Wyoming. The goal of the RMBC is to implement and expand a regional laboratory-based biomonitoring program to assess the extent and nature of human exposures to environmental toxicants, including estimates of background exposure to naturally occurring and industrial chemicals that have the potential to cause harm, and to help prevent disease resulting from such exposures. To accomplish this goal, the RMBC has developed five objectives: (1) increase regional laboratory capacity to conduct biomonitoring, (2) support and enhance the collaboration between laboratories, epidemiologists, local public health agencies, and other partners within the region, (3) conduct biomonitoring activities, (4) complement and support on-going bioterrorism and chemical terrorism preparedness efforts, and (5) complement and support on-going Environmental Public Health Tracking (EPHT) efforts.
Biomonitoring is particularly pertinent for this region since it is often sparsely represented or not represented at all on national surveys due to its low population density. The RMBC states share common demographic, geophysical and environmental characteristics, and have extensive histories of mining and Federal military operations. The RMBC includes 790 CERCLIS sites and 69 sites on or proposed for the National Priorities List. As a region, the RMBC states have some of the highest levels of arsenic in drinking water in the nation both from naturally occurring deposits as well as anthropogenic activities such as mining/milling and coal-fired power plants. Similarly, the RMBC states face exposure to radionuclides from deposits of uranium creating exposure both from drinking water as well as the mining/milling of uranium. Uranium exposure is of particular interest to Native Americans who constitute a potentially sensitive population due to the high prevalence of diabetes and the potential increased susceptibility to kidney toxicity associated with uranium exposure. Mining/milling, coal-fired power plants and natural sources have also led to RMBC lakes and streams with elevated levels of heavy metals. Mercury levels are of particular interest due to the potential exposure from the recreational fishing common to the region. Additional exposure issues identified by the RMBC needs assessment include the widespread use and concern over pesticides and volatile organic compounds (VOCs) in groundwater and stack emissions.
In order to accomplish the RMBC objectives, the Consortium will develop regional laboratory capacity by purchasing and distributing equipment, training personnel and implementing the demonstration projects. Surveillance and targeted-study activities are proposed which are designed to test, exercise, and subsequently strengthen the capability of the RMBC to conduct biomonitoring. Immediate testing of the RMBC will occur through methods development, sample processing, and analysis of archived samples from diabetes mellitus patients for arsenic. While the system is being tested with the archived patient samples, plans will be developed for the collection of samples from communities exposed to arsenic. These activities will test the ability to gather, process, disseminate, and analyze samples from multiple sources as well as generate data that will characterize the nature of exposure to arsenic, uranium, and other heavy metals. This includes developing historical exposure data inventories and mapping of biomonitoring, health effects, and historical exposure data. To support the ongoing nature of broad-based biomonitoring, clinics that provide primary health care and stored infant bloodspots will be explored as sources of urine and/or blood samples to be analyzed for environmental substances. These data will provide background exposure levels for substances including potential chemical terrorism agents (e.g. thiodiglycol, organophosphate metabolites) as well as identify geographic or temporally clustered exposures.
Arsenic and heavy metals analyses serve as the initial test of the capabilities and processes of the RMBC. However, analytic methods for other chemicals of concern to the region, including VOCs, cotinine, mercury, radionuclides, and organophosphate pesticides will be developed simultaneously by designated laboratories within the RMBC. By staging the development of these analyses, the logistical issues will have been addressed. As the RMBC lab capacity increases, samples will be submitted and analyzed for targeted exposed populations, epidemiologic studies, as well as routine or baseline biomonitoring surveillance. In addition to the arsenic and baseline studies, the proposed biomonitoring activities include:
- Determine exposure levels of persons living above VOC-contaminated groundwater.
- Determine the prevalence and levels of cotinine in individuals exposed to ETS.
- Examine the levels of mercury in people who consume fish from RMBC lakes.
- Describe the extent and level of exposure to radionuclides in drinking water.
- Provide baseline and targeted-population (i.e. agricultural, occupational, border-area, West Nile Virus) biomonitoring information for the levels of pesticide exposure.
Collaboration is an integral part of the RMBC Implementation Plan. Since the award of the planning grant, all of the states in the RMBC have been working to familiarize our partners with the biomonitoring project and establish a good working relationship with them, including county level public health officers, state agencies (e.g., agriculture, hazardous waste, environmental quality, fish, wildlife and parks), tribal leaders, coalitions, universities, community groups, extension services, occupational health facilities, and local clinics and hospitals. Nearly all of these partners have offered tremendous support and interest in the biomonitoring project. The RMBC will continue to collaborate with the public, public health partners, and complementary state and regional programs to address the problems identified during the needs assessment.
The RMBC Program goals and activities were selected based on their ability to increase ongoing lab capacity in the Region and to address environmental health issues identified during the needs assessments. The success of the program will be measured by the ability to accomplish these goals with our environmental health partners and to do so in the specified time and budget. The RMBC system will be evaluated annually for flexibility, acceptability, sensitivity, predictive value, representativeness, and timeliness. The level of usefulness and practical application of the information generated will also be evaluated based on the identification of inputs, activities, outputs, and short-term, intermediate, and long-term outcomes.
Dr. D. Mills, Lab Director at the NM DOH formed the RMBC and has led the team for the past two years of planning. It is composed of a representative from each member state's public health lab and a public health expert. This core team consists of chemists, epidemiologists, toxicologists, physicians, and veterinarians, with extensive public health experience, knowledge of their states' exposure issues, and a keen interest in biomonitoring to advance the understanding and improvement of environmental health in this region. The RMBC has 101 FTE chemists, 28 FTE environmental epidemiologists, 6 biomonitoring coordinators, approximately 70,000 sq. ft. of chemistry lab space and 5 of 6 State labs are both CLIA and EPA certified. In the RMBC plan, the biomonitoring coordinator would be retained for each of the states in addition to 1 FTE for sample processing/QA and 0.5 FTE for data management. The organizational structure consists of the core team, support members, and partners integrated through working committees and reviews to provide regulatory review, lab compliance, QA/QC, human subject protection, and fiscal accountability.
