What we need to know about bioterrorism preparedness: results from focus groups conducted at APIC 2000.

Infection control practitioners (ICPs) are important partners in enhancing the US public health infrastructure, both as essential recipients of continuing education and as instructors responsible for providing this education. Focus groups were conducted at APIC 2000, the annual meeting for the Association for Professionals in Infection Control and Epidemiology, Inc, to determine the ICPs' priorities for educational opportunities in bioterrorism preparedness and the preferred methods of education delivery. Focus group participants affirmed the need to provide education in sessions of less than 60 minutes, with use of a variety of technologies and methods of presentation such as video, Internet, and paper-based self-learning texts. The participants' comments suggested a lack of awareness by employees in health care institutions about the potential threat of bioterrorism in the United States and a deficiency in knowledge about the potential consequences of an attack. The focus group participants believed this lack of awareness also leads to unwillingness by their administrators to allocate funds for planning and education. Since it appears that ICPs will be looking for direction and expertise from the local health departments in their communities, the first subset of professionals to target for bioterrorism education and preparedness should probably be the public health professionals.

Background levels of non-ortho-substituted (coplanar) polychlorinated biphenyls in human serum of Missouri residents.

This study characterizes the levels of polychlorinated biphenyls (PCB) congeners PCB 77, PCB 81, PCB 126, and PCB 169, in a group of 150 men and women with no documented exposure to PCBs. Its purpose is to provide current referent levels of coplanar PCBs in Missouri residents and to compare those levels to levels reported in the literature from the United States and other countries. Although this study used an extensive questionnaire assessing potential sources of exposure, no positive relations were found between these exposure sources and participants' PCB levels. The PCB levels for the four congeners measured were lower than any reported in the literature. PCBs 126 and 169 are only two of the dioxin-like congeners; however, their contribution makes up 11% of the total TEQ. Age was significantly related to PCB 126 and PCB 169. For every one-year increase in age, both PCB congeners increased by approximately 0.4 parts per trillion (ppt). There was no gender difference for PCB 126; however, PCB 169 levels were 3 ppt higher in males than females.

A portable x-ray fluorescence instrument for analyzing dust wipe samples for lead: evaluation with field samples.

Dust wipe samples collected in the field were tested by nondestructive X-ray fluorescence (XRF) followed by laboratory analysis with flame atomic absorption spectrophotometry (FAAS). Data were analyzed for precision and accuracy of measurement. Replicate samples with the XRF show high precision with an intraclass correlation coefficient (ICC) of 0.97 (P<0.0001) and an overall coefficient of variation of 11.6%. Paired comparison indicates no statistical difference (P=0.272) between XRF and FAAS analysis. Paired samples are highly correlated with an R(2) ranging between 0.89 for samples that contain paint chips and 0.93 for samples that do not contain paint chips. The ICC for absolute agreement between XRF and laboratory results was 0.95 (P<0.0001). The relative error over the concentration range of 25 to 14,200 microgram Pb is -12% (95% CI, -18 to -5). The XRF appears to be an excellent method for rapid on-site evaluation of dust wipes for clearance and risk assessment purposes, although there are indications of some confounding when paint chips are present.

The reliability of 2,3,7,8-tetrachlorodibenzo-p-dioxin and toxicity equivalence measurements in Missouri residents.

This study evaluates the reliability of serum measurements of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and toxicity equivalence (TEQ) in individuals with no prior exposure to TCDD or dioxin-like compounds above background levels. Reliability was measured over three time-periods in the same individuals. TCDD and TEQ were measured in 127 and 128 participants. The values declined during the testing periods. Reliability coefficients for TCDD was 0.69 and for TEQ 0.91 but increased to 0.79 and 0.92, respectively, after removal of three outlying cases. Study results show good reliability over 22 months suggesting a consistency in the uptake and excretion of TCDD and other dioxin-like compounds.

Dioxin incinerator emissions exposure study Times Beach, Missouri.

PURPOSE: To determine whether living in the vicinity of a hazardous waste incinerator that was burning material contaminated with 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) increased TCDD and toxicity equivalencies (TEQ) in individuals living near the incinerator. METHODS: Participants were randomly chosen from an area close to the incinerator and compared to participants outside of the exposure area. TCDD and related compounds were measured in blood serum before incineration, four months after incineration started, and at the end of incineration. RESULTS: Lipid adjusted serum levels of TCDD and TEQ decreased from pre-incineration to four months after incineration, and decreased further by the end of incineration. CONCLUSION: Incineration of TCDD did not result in any measurable exposure to the population surrounding the incinerator.

Relationship between lead mining and blood lead levels in children.

The authors studied blood lead levels of 226 randomly selected children, aged 6-92 mo, who lived in either a lead-mining area or a nonmining area, and 69 controls. The authors sought to determine to what extent mining activities contributed to blood lead levels in the children. The mean blood lead levels in the study and control groups were 6.52 microg/dl and 3.43 microg/dl, respectively. The corresponding proportions of children with elevated blood lead levels were 17% and 3%. Soil and dust lead levels were up to 10 times higher in the study than the control group. Elevated blood lead levels appeared to result from exposure to both lead-mining waste and lead-based paint. Mining waste was the cause of the higher prevalence of elevated blood lead levels in these children.