7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta
12.1 Yome
1. Overview of Human Biomonitoring Initiatives Under the
Government of Canada’s Chemicals Management Plan
International Symposium on Biological Monitoring
September 10, 2013
Manchester, UK
Julie Yome
Chemicals Surveillance Bureau
Healthy Environments and Consumer Safety Branch
Health Canada
2. Chemicals Management Plan
In 2006, the Government of Canada launched the Chemicals Management Plan
(CMP) to advance and improve the management of chemical substances and
safeguard the health of Canadians
Risk Assessment
Research
Reporting,
Communication
& Cooperation
Risk
Management
Monitoring &
Surveillance
Compliance,
Promotion &
Enforcement
2
4. Canadian Health Measures Survey
National survey on the general health and lifestyles of
Canadians to provide information on chronic and
infectious disease, physical fitness, nutrition, and other
factors that influence health – includes a biomonitoring
component
Partners:
Statistics Canada
Health Canada
Public Health Agency of Canada
Design
• Cross-sectional survey carried out in 2 year cycles
• Age groups: 3-5, 6-11, 12-19, 20-39, 40-59, 60-79 years
• Nationally representative of 96% of the Canadian
population
Household Component
• Interview
• Indoor air (≥ cycle 2) and tap water (≥ cycle 3) sampling
Mobile Examination Centre Component
• Direct physical measures, including blood and urine
4
5. CHMS Milestones
2008
2009
2010
2011
2012
2013
2014
2015
2016
Mar 2007 – Feb 2009
15 sites
Cycle 1 biomonitoring
report (August 2010)
6-79 years (n = 5,600)
92 chemicals
Cycle 2
biomonitoring
report (April 2013)
Aug 2009 – Nov 2011
18 sites
3-79 years (n = 6,400)
91 chemicals
Jan 2012 – Dec 2013
16 sites
3-79 years (n = 5,700)
105 chemicals
Cycle 4
Cycle 3
Cycle 2
Cycle 1
2007
Cycle 3 biomonitoring
data to be published
(May 2015)
Jan 2014 – Dec 2015
16 sites
3-79 years (n = 5,700)
same chemicals
as Cycle 3
5
6. First Nations Biomonitoring Initiative
The FNBI is a national human biomonitoring health survey for
First Nations people living on reserve (south of 60o) conducted
in 2011
Partnership between
Health Canada & the
Assembly of First
Nations
Objectives
• Establish baseline information on environmental chemicals in
First Nations across Canada
• Compare exposure levels of First Nations’ peoples with the
CHMS population
Components
• Lifestyle questionnaire
• Direct physical measurements (e.g., weight, BMI, blood
pressure, etc.)
• Biospecimen collection (blood and urine)
Survey Design
• 13 randomly selected First Nation communities across Canada
• Over 500 randomly selected participants (40-45 per community)
• Participants - First Nation living on reserve, 20+ years old
• 97 chemicals measured – align with CHMS cycle 1
6
7. Northern Contaminants Program
Established in 1991 in response to concerns about human
exposure to elevated levels of contaminants in wildlife
species important to traditional diets of northern Aboriginal
peoples
Key Objectives
• Reduce/eliminate contaminants in traditional/country
foods
• Support informed decision making on food use for
individuals and communities
Approach
• Government/stakeholder partnership
• Biomonitoring studies over several years in various
Canadian Arctic communities
• Focus on metals (Pb, Cd, Hg, etc.) and persistent
organic pollutants (PCBs, PBDEs, etc.)
7
8. Maternal-Infant Research on Environmental Chemicals (MIREC)
Principal Investigators
Tye Arbuckle, Health Canada
William Fraser, Université de Montréal
Study Design
• 2,000 pregnant women recruited during 1st trimester and
followed until 8-10 weeks after delivery
• 10 clinical sites across Canada
• Data collection: 2008-2011
• First results expected: 2013
• Biobank established
Primary Objectives
• Assess what pregnancy health risks, if any, are associated with
exposure to heavy metals (e.g., lead, mercury, etc)
• Obtain baseline data on maternal and neonatal exposure to
priority environmental chemicals (via biomonitoring)
8
9. MIREC Research Platform
Arbuckle et al. 2013. Cohort profile: the maternal-infant research on environmental chemicals
research platform. Paediatr Perinat Epidemiol. 2013 Jul;27(4):415-25.
MIREC-ID
• Follow-up on infant development at birth and 6 months of age to evaluate whether
prenatal exposure to environmental chemicals had any effect on infant growth,
development, and behaviour
MIREC-CD3
• Follow-up on child development at 3 years of age
• Online survey to collect data on potential links between prenatal exposures, language,
and behaviour
MIREC-CD Plus
• Follow-up on child development between 15 months to 5 years of age
• Assess exposure to metals (in blood of children < 3 years of age), and measure growth,
development, and behaviour
Biobank
• Established to store biospecimens and data for future research
9
11. Blood guidance level for
general adult population
(20 μg/L)
Blood Total Mercury - CHMS Cycles 1 & 2
Proposed blood guidance level (8 μg/L) for children and women of childbearing age (Legrand et al. 2010)
11
12. Mercury – CHMS Cycle 1 compared to FNBI
*
12
* Data should be used with caution – COV between 16.6% and 33.3%
13. Mercury - Northern Contaminants Program
Total mercury concentrations (µg/L whole blood) in pregnant
women in Arctic Canada
13
14. Mercury - Women of Child-Bearing Age Exceeding 8µg/L
Differences between populations
Down from 53%
in 1997
20%
2.2%
2.7%
Down from 10%
in 1997
1.9%
14
18. For Additional Information
Julie Yome
Healthy Environments and Consumer Safety Branch
Health Canada
Ottawa, Canada
Telephone: (613) 957-4188
julie.yome@hc-sc.gc.ca
Human Biomonitoring of Environmental Chemicals
www.healthcanada.gc.ca/biomonitoring
Canadian Health Measures Survey
www.hc-sc.gc.ca/ewh-semt/contaminants/human-humaine/chms-ecms-eng.php
Maternal-Infant Research on Environmental Chemicals
www.mirec-canada.ca
www.hc-sc.gc.ca/ewh-semt/contaminants/human-humaine/mirec-eng.php
Northern Contaminants Program
www.aadnc-aandc.gc.ca/ncp
First Nations Biomonitoring Initiative
www.afn.ca/uploads/files/afn_fnbi_en_-_2013-06-26.pdf
Other Canadian Health Monitoring and Surveillance Initiatives
www.chemicalsubstanceschimiques.gc.ca/plan/surveil/index-eng.php
18