Biomonitoring: A Public Perspective
By Jessica Nelson MPH
Boston University School of Public Health, Superfund Basic Research Program, Research Translation Coordinator
This article is the fourth in the series "From Research to Real Life" that GBPSR presents in conjunction with the Boston University Superfund Basic Research Program (BUSBRP).
We hope this information encourages you to become more involved in PSR programs or other activities that address preventing toxic exposures that may jeopardize public health.
Biomonitoring the practice of measuring chemicals in peoples' body fluids or tissues has recently gained increasing attention as the technology has advanced and its use has expanded. Scientists can now measure more kinds of chemicals in a sample of blood, for example, and can do so at amazingly low levels of up to parts-per-quadrillion. These technological improvements, however, have outpaced our knowledge about the health effects of the chemicals we can measure.
Biomonitoring Has Varied Uses
Epidemiologic studies use biomonitoring to assess peoples' exposure to chemicals such as pesticides and mercury. Government agencies conduct routine surveillance of a sample of the population to track trends in exposures over time and to assess how well public health interventions are working. The U.S. Centers for Disease Control and Prevention (CDC) regularly tests the blood and urine of a representative sample of Americans the agency's 2005 report looked at the presence of 148 chemicals in more than 2,000 people. Community and environmental advocacy groups also use biomonitoring for public education and political purposes.
These varied uses and the significant ethical, social, and political questions they raise make biomonitoring a hot topic. The National Research Council released a report on biomonitoring in July 2006, and other technical working groups have convened to discuss these issues.
A Consensus Conference is Convened in Boston
One important voice missing in these conversations has been that of the general public. In Fall 2006, the Boston University School of Public Health organized the Boston Consensus Conference on Biomonitoring to gather the public's input on biomonitoring. Supported by the National Institute of Environmental Health Sciences (NIEHS) and the BU Superfund Basic Research Program (also funded by the NIEHS), the Consensus Conference brought together 14 lay people from the Boston area to consider ethical, legal, social, and scientific issues related to biomonitoring.
| Lay panel members of the Boston Consensus Conference on Biomonitoring answer questions.|
(L—R) are Garry Faradijian, Zara Zsido, Martha Manning, Reynaldo Balmes, Edward Shaddock.
The Consensus Conference model is used in Denmark to stimulate informed social debate on science and technology issues and to inform policymaking. It involves recruiting a "lay panel" of residents, similar to how jury duty is organized in the U.S. Panelists were recruited by placing and posting fliers, and were selected to reflect the demographics of the City of Boston.
Over two weekends, the lay panel learned about biomonitoring through a carefully planned program. Aided by a team of professional facilitators, the panelists identified and articulated their own key questions and concerns. During a third weekend, they posed these questions to a panel of six experts, including scientists, a health law attorney, and representatives from state government, a chemical industry trade group, and an environmental NGO.
Future Consideration is Warranted as the Use of Biomonitoring Expands
The Consensus Statement that emerged identifies five areas that warrant further consideration as the use of biomonitoring expands. It calls for educating the general public about biomonitoring, establishing responsible surveillance programs at the state and federal levels, addressing the possibility of discrimination by employers or health insurers on the basis of biomonitoring results, and focusing on how biomonitoring data could be used to influence corporate and government behavior and spur the development of "green chemistry."
The panel specifically recommends that surveillance program oversight boards be composed of diverse stakeholders, including individuals from affected communities, and that a precautionary approach be used when biomonitoring data reveal increasing trends in exposure. The statement also concludes that individuals should be able to choose whether or not they want to receive biomonitoring results. Finally, the statement recommends that biomonitoring data be treated as a protected class of medical information.
The deliberations and results of the Boston Consensus Conference on Biomonitoring show that an informed public is capable of understanding technical issues and contributing valuable input that furthers discussions about science and technology policy.
For more information on this topic: http://www.biomonitoring06.org/
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