Protocol - Concentrations of Trace Metals

Administer the following questions prior to blood collection.

1. Do you have hemophilia or any bleeding disorder?

[ ] Yes

[ ] No

[ ] Don’t Know

[ ] Refused

      • If the participant answers "Yes" or "Don’t know," or refuses to answer, blood will not be collected.

2. Have you had cancer chemotherapy within the past 4 weeks?

[ ] Yes

[ ] No

[ ] Don’t Know

[ ] Refused

      • If the participant answers "Yes" or "Don’t know," or refuses to answer, blood will not be collected.

3. Have you had any problems with a blood draw in the past?

[ ] Yes

[ ] No

[ ] Don’t Know

[ ] Refused

• If the participant answers "Yes," go to question 4.
• If the participant answers "No," "Don’t know," or refuses to answer, go to question 5.

4. What problems have you had with a blood draw in the past?

______________________________

• Record the types of problems that the participant experienced during previous blood draws.
• If the participant refuses to answer or does not remember specifically what type of problem was experienced in the past, record and go to question 5.

5. When was the last time you had anything to eat or drink other than water?

Date ____________ mm/dd/yyyy

Time ____________ am/pm

6. Have you had sweetener or milk added to a drink, such as coffee or tea, in the last 8 hours?

[ ] Yes

[ ] No

[ ] Don’t Know

[ ] Refused

• Record the participant’s response.
• "Sweetener" includes sugar, honey, and flavored creamers. If the participant consumed an artificial sweetener in coffee, tea, or a diet soda, record "No."

7. Have you had alcohol such as beer, wine, or liquor in the last 8 hours?

[ ] Yes

[ ] No

[ ] Don’t Know

[ ] Refused

8. Have you chewed gum, or used breath mints, lozenges, cough drops, or other cough or cold remedies in the last 8 hours?

[ ] Yes

[ ] No

[ ] Don’t Know

[ ] Refused

9. Have you used antacid, laxatives, or anti-diarrheal medications in the last 8 hours?

[ ] Yes

[ ] No

[ ] Don’t Know

[ ] Refused

10. Have you taken a dietary supplement such as vitamins or minerals in the last 8 hours?

[ ] Yes

[ ] No

[ ] Don’t Know

[ ] Refused

11. Has a doctor ever told you that you had diabetes?

[ ] Yes

[ ] No

[ ] Don’t Know

[ ] Refused

• If the participant answers "Yes," go to question 12.
• If the participant answers "No" and is pregnant probe "This includes gestational diabetes." If the participant still answers "No" after probe, prepare to draw participant’s blood.
• If the participant is not pregnant and answers that she had gestational diabetes while pregnant, indicate that this does not include gestational diabetes and prepare to draw the participant’s blood.
• If the participant answers "No" and is not pregnant, prepare to draw the participant’s blood.

12. Have you taken any insulin in the last 8 hours?

[ ] Yes

[ ] No

[ ] Don’t Know

[ ] Refused

      • Record the participant’s response and prepare to draw the participant’s blood.

The entire standard operating procedure from the National Children’s Study that includes the questions, venipuncture supplies, and venipuncture procedure appears here.

Follow a standard venipuncture protocol but lavender top vacutainer tube must be collected first. Draw the blood with a stainless steel needle and use a pre-screened vacutainer tube.

The optimal amount of blood in lavender top tube is 1 to 2 ml. The minimum amount for analyses is 0.4 ml.

The lavender top tube includes a strong anticoagulant and the whole blood should never be centrifuged. The lavender top tube with blood may be refrigerated during transport. The blood may be aliquoted to cryovials and placed in a -20^◦ C freezer prior to analyses.

Concentrations of cadmium, lead, manganese, selenium, and mercury are measured in EDTA-anticoagulated whole blood using high performance liquid chromatography coupled to inductively-coupled-plasma dynamic-reaction-cell mass spectrometry (ICP-DRC-MS).

Levels of concern for mercury in blood are >100 μg/L for children (6 yr and younger) and >200 μg/L for adults. Levels of concern for cadmium in blood is >5 μg/L (CDC/DLS, 2012). Elevated blood levels are 5 μg/dL for children (6 yr. and younger) and adults (CDC, 2012). The entire laboratory procedure is available here.