Grantee Research Project Results

2003 Progress Report: Dose-Response of Nitrate and Other Methemoglobin Inducers on Methemoglobin Levels of Infants

EPA Grant Number: R829781
Title: Dose-Response of Nitrate and Other Methemoglobin Inducers on Methemoglobin Levels of Infants
Investigators: VanDerslice, Jim
Institution: Washington State Department of Health
EPA Project Officer: Page, Angela
Project Period: September 2, 2002 through September 1, 2005 (Extended to September 1, 2007)
Project Period Covered by this Report: September 2, 2002 through September 1,2003
Project Amount: $594,934
RFA: Health Effects of Chemical Contaminants in Drinking Water (2001) RFA Text | Recipients Lists
Research Category: Drinking Water , Human Health , Water

Objective:

The objectives of this research project are to: (1) estimate the intake of methemoglobin inducers (i.e., nitrate, copper, chlorination products, medications) among a sample of infants; (2) generate age-specific baseline distributions of methemoglobin levels for healthy infants apparently unexposed to methemoglobin inducers; (3) estimate the dose-response relationships between the intake of exogenous methemoglobin inducers (nitrate, copper, chlorination products) and the level of peripheral blood methemoglobin in infants; (4) estimate the effect of potential endogenous production of nitrite (i.e., symptoms of infection and gastrointestional distress) on the level of methemoglobin in infants; and (5) examine the joint effects of simultaneous exposures to multiple methemoglobin inducers on methemoglobin levels.

Progress Summary:

This project has encountered obstacles that have yet to be resolved. Most of the study protocols, procedures, and instruments have been developed. Furthermore, the study was submitted and conditionally approved by the Washington State Institutional Review Board on February 25, 2003. At that time, we began discussions with the Benton-Franklin Health District (BFHD) to make preparations to begin the study. The BFHD was to receive a contract from the Washington State Department of Health (DOH) to hire the necessary field personnel, purchase equipment and supplies, and provide a base of operations for fieldwork. The primary personnel to be used for conducting interviews were public health nurses and bilingual technicians. Nurses are required, as we are collecting a small volume of blood via finger or heel sticks for the methemoglobin tests. The BFHD has had great difficulty in recruiting public health nurses and since last year has had three or more open nursing positions of its own. They have not been able to fill these positions because of the high demand in the local area. The BFHD could not hire nurses for this study until they had already filled their existing open positions. Until this employment situation can be resolved, the study cannot move forward as planned.

Future Activities:

Future activities are to explore three alternatives. First, we have determined that registered phlebotomists, nursing technicians, and certified healthcare assistants also may draw blood without physician supervision in a nonmedical setting. We are investigating the possibility of recruiting these personnel through the BFHD for part-time weekend work conducting home visits. Second, we are exploring the possibility of contracting directly with appropriate individuals (nurses, technicians) to conduct home visits and interviews. Because these contracts would be for more than $5,000, we would need to demonstrate competition in the contracting process per state rules. This may be difficult to do given the type of services and number of people we would need to engage. Writing the contracts and managing the contractors also will increase the amount of administrative work on the part of the DOH. Third, we are contacting other regional institutions (two universities and a nonprofit organization) to determine if they would be interested in providing the same functions envisioned for the BFHD. These organizations would not be constrained by having to fill existing nursing positions before filling positions for this study. As soon as a feasible alternative has been identified, we will submit a study modification to the Institutional Review Board for final approval, hire staff, and begin data collection.

Journal Articles:

No journal articles submitted with this report: View all 6 publications for this project

Supplemental Keywords:

drinking water, exposure, health effects, human health, dose-response, population, infants, children, susceptibility, chemicals, nitrogen, bacteria, community-based, survey, epidemiology, northwest, Washington, WA, U.S. EPA Region 9, contamination, nitrate contamination, methemoglobin formation, methemoglobin,, RFA, Health, Scientific Discipline, Water, Health Risk Assessment, Risk Assessments, Environmental Chemistry, Analytical Chemistry, Children's Health, Biochemistry, Drinking Water, health effects, human health, dietary exposure, other - exposure, methemoglobin formation, nitrate contamination, water quality, human exposure, chemical contaminants, dietary ingestion exposures, chemical exposure, children, drinking water contaminants, exposure, groundwater, methemoglobin, children's vulnerablity, human health effects, human health risk, assessment of exposure, exposure and effects, exposure assessment

Progress and Final Reports:

Original Abstract

The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Conclusions drawn by the principal investigators have not been reviewed by the Agency.