National Health and Nutrition Examination Survey NHANES

The prevalence of overweight and obesity continues to increase, keeping this disease a major public health concern. Results from the most recent National Health and Nutrition Examination Survey (NHANES) reflect an increased combined prevalence for overweight and obesity among adults... 

Cardiovascular Effects. There is currently considerable scientific debate as to whether there is a causal relationship between lead exposure and hypertension. Another area of controversy is whether African Americans are more susceptible to the cardiovascular effects of lead than are whites or Hispanics. The evidence from both occupational studies and large-scale general population studies (i.e., National Health and Nutrition Examination Survey [NHANES II], British Regional Heart Study [BRHS]) is not sufficient to conclude that such a causal relationship exists between PbB levels and increases in blood pressure. The database on lead-induced effects on cardiovascular function in humans will be discussed by presenting a summary of several representative occupational studies followed by a discussion of the findings from the large-scale general population studies. 

Blood lead levels measured as a part of the National Health and Nutrition Examination Surveys (NHANES) revealed that between 1976 and 1991, the mean PbB levels of the U.S. population aged from 1 to 74 years dropped 78%, from 12.8 to 2.8 pg/dL. The prevalence of PbB levels 10 pg/dL also decreased sharply from 77.8% to 4.3%. The major cause of the observed decline in PbB levels is most likely... 

Brody DJ, Pirkle JL, Kramer RA, et al. 1994. Blood lead levels in the US population. Phase 1 of the Third National Health and Nutrition Examination Survey (NHANES III, 1988 to 1991). J Am Med Assoc 272 277-283. 

The National Health and Nutrition Examination Surveys (NHANES). JAMA 272 284-291. 

A report entitled Chemical Trespass was issued in May 2004 by the Pesticide Action Network (Schafer et al., 2006). It contained detailed analysis of 2000/01 National Health and Nutrition Examination Survey (NHANES) OP urinary metabolite data and used published methods to estimate exposure levels to parent compounds from creatinine corrected urinary metabolite levels. They focused on chlorpyrifos and its metabolite 3,4,6-trichloro-2-pyridinol (TCP), and found that chlorpyrifos exposures for children ages 6-11 and 12-19 exceeded EPA s chronic population-adjusted dose (cPAD) by surprisingly wide margins. Geometric mean TCP levels were 3 to 4.6 times higher than the EPA-estimated safe dose, as shown in Fig. 14.2. The more heavily exposed children received daily doses more than ten times the safe level. 

The Third National Health and Nutrition Examination Survey (NHANES III, 1988-94) Reference Manuals and Reports, October 1996. 

Hollowell, J.G. et al., Serum TSH, T(4), and thyroid antibodies in the United States population (1988 to 1994) National Health and Nutrition Examination Survey (NHANES III), J. Clin. Endocrinol. Metab., 87, 489, 2002. 

Mirex residues in human blood serum were measured as part of the Second National Health and Nutrition Examination Survey (NHANES II), conducted between 1976 and 1980. Of the 4,038 samples analyzed, mirex concentrations ranged from not detectable to detected but below quantifiable levels (10 pig/L [ppb] (Stehr-Green 1989). 

In recent years there has been an upsurge in efforts to move from indirect measures of human exposure (obtained by measurements of chemicals in environmental media and estimation of dose accrued from contact with those media) to direct measures of the concentrations of chemicals in the body, typically in blood and in elimination pathways such as urine and hair. The most significant effort in this direction in the United States has been undertaken as part of the CDC s National Health and Nutrition Examination Survey (NHANES). 

Estimated from one 24-h dietary recall conducted in the National Health and Nutrition Examination Survey (NHANES, 1999-2000). Data are based on a total otn = 8640 individuals (variously spread across gender and age groups) deemed to have complete and reliable recall to include in the analyses (Wright et al, 2003). Age categories are those recommended in NHANES. 

Rates for the incidence of end stage renal disease have increased for which hypertension is the second most common cause. It has also been stated that hypertension control rates have not continued to improve (National Health and Nutrition Examination Survey, NHANES III, Phase 1) from 1991 to 1994. These disturbing trends support the need to enhance public and professional education and to translate the results of research into improved health. 

The Third National Health and Nutrition Examination Survey (NHANES III), a national study conducted by the National Center for Health Statistics (NCHS) and the U.S. Centers for Disease Control (CDC) reported that 40% of Americans had used a dietary supplement in the month before they were interviewed for the study. Although NHANES did not break down supplement use into specific subtypes, the data gives some interesting insights into the growing acceptance of dietary supplement products in America. 

The current scientific infrastructure to support the committee s research recommendations is severely limited. Improvements in research-related infrastructure are needed to support these recommendations and to enhance the value of biomonitoring activities. The infrastructure needs encompass enhancing laboratory capabilities, expanding the scope and utility of CDC s National Health and Nutrition Examination Survey (NHANES) data, maximizing the use of collected human samples, and fostering international biomonitoring collaboration. Many of these recommendations for infrastructure improvement are cost-effective because they rely on expansion of structures and activities that are already in place. 

Centers for Disease Control and Prevention—National Health and Nutrition Examination Surveys (NHANES) National Reports on Human Exposure to Environmental Chemicals Provides continuing assessment of U.S. population s exposure to environmental chemicals using biomonitoring data from NHANES. First National Report on Human Exposure to Environmental Chemicals (First Report) was issued in March 2001. Second Report, released in January 2003, presents biomonitoring exposure data on 116 environmental chemicals for noninstitutionalized, civilian U.S. population in 1999-2000. Third report was released in July 2005 and includes data on 148 chemicals (CDC 2005). 

Schober, S. 2005. National Health and Nutrition Examination Survey (NHANES) Environmental Biomonitoring Measures, Interpretation of Results. Presented at the Second Meeting on Human Biomonitoring for Environmental Toxicants, April 28, 2005, Washington, DC. 

Hypertension is the most common cardiovascular disease. Thus, the third National Health and Nutrition Examination Survey (NHANES III), conducted from 1992 to 1994, found that 27% of the USA adult population had hypertension. The prevalence varies with age, race, education, and many other variables. Sustained arterial hypertension damages blood vessels in kidney, heart, and brain and leads to an increased incidence of renal failure, coronary disease, cardiac failure, and stroke. Effective pharmacologic lowering of blood pressure has been shown to prevent damage to blood vessels and to substantially reduce morbidity and mortality rates. Many effective drugs are available. Knowledge of their antihypertensive mechanisms and sites of action allows accurate prediction of efficacy and toxicity. As a result, rational use of these agents, alone or in combination, can lower blood pressure with minimal risk of serious toxicity in most patients. 

Dunn, L.B., Damesyn, M., Moore, A.A., Reuben, D.B., and Greendale, G.A., Does estrogen prevent skin aging Results from the First National Health and Nutrition Examination Survey (NHANES I), Arch. Dermatol., 133, 339-342, 1997. 

The considerably higher blood Pb levels in industrial populations reflect widespread environmental Pb pollution. However, data obtained from the Second National Health and Nutrition Examination Survey (NHANES II) indicate that there has been a reduction in the overall mean blood-lead level of the U.S. population during the period 1976 through 1980 from 15.8 mg/dl to 10.0 mg/dl (Lin-Fu 1982). It is suggested that an increased use of unleaded gasoline by the U.S. population may be responsible for the observed decrease. 

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